Educator Feedback - Connect Kids to Medicaid and CHIP Coverage

Name*

First Last

Email*

School/Organization*

Address*

Street Address City State ZIP Code

Grade(s) You Teach

1. Have you used (or do you plan to use) the CONNECT KIDS TO MEDICAID AND CHIP COVERAGE program?

If YES, how many students used (or will use) the program at your school?

If NO, why not?

2. Have you shared the program with other teachers at your school?

If YES, how many?

If NO, why not?

3. Please rate this program's appeal to students.

4. Please rate this program's educational effectiveness.

5. Are you interested in receiving more free educational programs from YMI?

6. Have you downloaded free teaching resources from the YMI website?

If YES, which programs?

7. Are you interested in joining the YMI Educator Advisory Board to review future programs?

Please share any additional comments or suggestions.

Educator Feedback – Connect Kids to Medicaid and CHIP Coverage