Va-LEND Module Evaluation-ASD and Co-Occurring Conditions
Email *
First and Last Name *
What is your role in working with children/families with special health care needs/disabilities? (For example: Occupational Therapist, Social Worker, Special Education, Parent, Self Advocate, etc.) *
What is your zip code? *
Date Module Completed *
MM
/
DD
/
YYYY
I increased my awareness of the health care needs of children with autism spectrum disorder, developmental disabilities, and other special needs. *
Strongly Disagree
Strongly Agree
I increased my awareness of interdisciplinary, family-centered, culturally/linguistically competent, evidenced-based and community-based approaches to services and supports. *
Strongly Disagree
Strongly Agree
In what ways might you use what you’ve learned from this module? *
Name three of the things you enjoyed learning the most about: *
What is your overall level of satisfaction with this module? *
Highly dissatisfied
Highly satisfied
Thank you!
Thank you for completing the evaluation. Your certificate will automatically be emailed to you as an attachment upon submission of this form.
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