Clubify Defibrillator Survey
Thank you for participating in our 60 second defibrillator awareness survey. The information you give will be treated anonymously and used to inform a study of defibrillator awareness among club members.
What is the name of your club?
Your answer
What type of club is it?
What age range are you in?
To your knowledge, does your club have a defibrillator?
If yes, do you know where that defibrillator is located in your club?
Do you know who within your club to contact in an emergency (name and phone number)?
Have you ever been in a situation where a defibrillator needed to be used on someone?
Have you ever received training on how to use a defibrillator?
If your previous answer was yes, when did you receive the training?
If this was more than a year ago, have you received refresher training?
Is your defibrillator certification currently up to date?
How confident are you about using a defibrillator in a real situation? 1 - Not confident 10 - Very confident.
How confident are you that you would know how to react in an emergency situation (i.e. what to do and who to call within your club)? 1 - Not confident 10 - Very confident.
If you would like to find out the results of this survey, please add your email address here.
Your answer
Thank you for taking the time to complete our survey!
Never submit passwords through Google Forms.
This form was created inside of Clubify. Report Abuse - Terms of Service - Additional Terms