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Seizure Recognition & Response Feedback Form
Contact Name
*
Organization
*
Presenter Name
*
Date of Presentation
*
Participants' knowledge of epilepsy increased
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Participants are able to recognize the various types of seizures
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Participants are now able to respond to a seizure
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Speaker was knowledgeable, organized, and communicated well
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Speaker maintained my interest and handled questions well
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Slides/handouts were effective
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
I would recommend this presentation to others
*
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Comments
How did you hear about the free seizure trainings?
*
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EFMN Email
Social media/online
Postcard
Other
Are you aware of another organization that would benefit from this training?
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Yes
No
Organization
Contact person
Contact phone