Follow-Up Survey - Up and Away and Out of Sight

Name*

First Last

Email*

School*

Address*

Street Address City State ZIP Code

1. Have you used (or do you plan to use) the "Up and Away and Out of Sight" program?

If YES, how many parents received the program materials?

If NO, why not?

2. Did you or do you plan to share the program with other teachers?

If YES, how many teachers?

If NO, why not?

3. Please indicate your overall impression of the program materials.

4. Did you display the wall poster?

If YES, for how long?

If NO, why not?

5. Did you distribute the Parent Letter or e-newsletter article from CDC?

If NO, why not?

6. Did you download any of the additional "Up and Away" resources from the YMI website?

If YES, which additional resources did you download? (Check all that apply.)

7. Would you be interested in receiving free parent-child health related educational materials of this nature in the future?

8. Have you downloaded any other free teaching materials from the YMI website?

If YES, which materials?

Please share any additional comments or suggestions.

Follow-Up Survey – Up and Away and Out of Sight