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::TB Related Links

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Product and Site Feedback Form

Feedback is invaluable to us so that we can provide better services and products. Please fill out the product feedback form below based on your evaluation of our product(s) and our web-site.

First name     Last name

Title

Organization

Street address

City   State      Zip

Phone                    Fax

Email

Type of Organization: (check all that apply)

State/city/county hospital Drug treatment facility
Private hospital Private provider
State/city/county health department CorrectionaI Institution
Nursing home Clinic
Community-based organization Other (specify)

What percentage of time do you spend on TB-related issues?        

< 25% 25-50% 50-75% >75%

Web-Site Feedback Section

Please give us feedback on our web-site below to better assist future users.

Products Feedback Section

How did you learn about our TB education materials? ( check all that apply)       

Co-worker/supervisor Advertisement (flyer, publication cover, newsletter, journal)
Conference/presentation Received by mail without making a specific request
Website Other (specify)

How have you used our TB educational materials? (check all that apply)

Training your own health staff How many trained?
Training outside health staff How many trained?
Rethinking program design and/or management  
Providing direct patient care  
Other (Specify)
If you used the materials in a training activity, how did participants respond to the materials?

    

PLEASE SELECT ONE RESPONSE FOR EACH QUESTION BELOW:

If   1 = strongly disagree     2 = disagree     3 = agree     4 = strongly agree

EDUCATIONAL PRODUCT

 
QUESTION



Tuberculosis:
Six Case
Studies
(booklet)

Improving Treatment Completion
for LTBI
among HCWs (booklet)
Social Support
Services
for TB
Clients
Treatment of
LTBI
(Clinic Poster)
Treatment
of LTBI (reference card)

1 .




This document addresses an important issue in TB control in the United States.
2.





This document includes all the essential information to enable me to do what its title suggests.
3.




The format and presentation make the information easy to find and use.
4.

I plan to use this again in my program.
5.

What is the most helpful aspect of these materials?

6.

For future editions I would suggest the following changes:

7.

I am willing to be contacted for further
information.

Yes No

I have completed all questions above and am ready to submit.