Follow-Up Survey: Over-the-Counter Medicine Safety

Name*

First Last

Email*

School*

School Address*

Street Address City State ZIP Code

1. Have you used or do you plan to use the OVER-THE-COUNTER MEDICINE SAFETY educational program? (If NO, please share this survey with the teacher who used or plans to use the program.)

Yes
No

2. What grades do you teach?

Grades 5-6
Grades 7-8
Both

3. What do you like best about the OVER-THE-COUNTER MEDICINE SAFETY educational program? (Please choose one.)

Lesson Plans/Activity Sheets
Poster
Online Games
Online Videos
Digital Storybook
Family Resources
School Nurse Resources

4. Overall, how would you rate the usefulness of the the OVER-THE-COUNTER MEDICINE SAFETY educational program?

Extremely useful
Very useful
Somewhat useful
Not useful

5. Do you feel that your students have a greater understanding of the importance of OTC medicine safety after using this program?

Yes
No

6. Please evaluate these components of the program.

Poster

Teacher's Guides

Activities

Family Letter in English/Spanish

7. Please evaluate the program's website resources (at www.ymiclassroom.com/otcmedsafety).

OTC Medicine Safety Microsite

School Nurse Resources

Family Resources

8. Please evaluate the program's games and videos.

"A Social Media Challenge" Video

"Sidelined at Practice" Video

Trivia Game

9. Did you or do you plan to share this program with other teachers?

Yes
No

If YES, how many teachers? (Please choose one.)

1-2 Teachers
3-4 Teachers
5 or more Teachers

10. At which type of school do you teach?

11. What is your role? (Please check all that apply.)

Teacher
Coach
School Nurse
Guidance Counselor
Other

12. What was your favorite part of the OVER-THE-COUNTER MEDICINE SAFETY educational program?