EXCITE Design Phase Immediate Feedback

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Based on the Launch Workshop held September 22nd, please give us your feedback!

Do you plan to attend EXCITE: Design Phase Workshops beginning in October?

Yes

Maybe

How prepared are you to complete the application for EXCITE: Design Phase?

Very well prepared

Somewhat prepared

Somewhat unprepared

Not at all prepared

How prepared are you to contact your Extension administrator to obtain a letter of support for the EXCITE: Design Phase application?

Very well prepared

Somewhat prepared

Somewhat unprepared

Not at all prepared

How prepared are you to identify a Principal Investigator of EXCITE: Design Phase?

Very well prepared

Somewhat prepared

Somewhat unprepared

Not at all prepared

How prepared are you to determine which personnel expenses can be covered by the EXCITE: Design Phase $10,000 award?

Very well prepared

Somewhat prepared

Somewhat unprepared

Not at all prepared

How prepared are you to identify internal partners for EXCITE?

Very well prepared

Somewhat prepared

Somewhat unprepared

Not at all prepared

How prepared are you to identify public health partners, federally qualified health centers, rural health centers, or other partners that can provide adult immunizations as part of EXCITE?

Very well prepared

Somewhat prepared

Somewhat unprepared

Not at all prepared

Your Name and Institution: *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Extension Foundation. Report Abuse

Forms