Youth Mental Health Module Series Feedback
Please take a few minutes to complete this survey regarding the mental health module you completed.
*
1.
Grade
(Required.)
*
2.
School
(Required.)
*
3.
Which module did you complete?
(Required.)
Suicide Prevention
Anxiety
Substance Use and Mental Health
Marijuana Use and Mental Health
*
4.
Did you complete this module in:
(Required.)
A Class
After School Program
On your own
Other (please specify)
5.
If you selected you completed this module in a class or afterschool program, please identify which class or program.
*
6.
How relevant do you feel the module was to issues youth commonly face?
(Required.)
Not relevant at all
Somewhat relevant
Neither irrelvant or relevant
Relevant
Very relevant
Not relevant at all
Somewhat relevant
Neither irrelvant or relevant
Relevant
Very relevant
7.
Do you have any comments or feedback you would like to provide?
