2014 Annual First Breath Provider Survey

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Welcome to the First Breath Annual Provider Survey! Thank you so much for taking the time to complete this survey. Your feedback is incredibly valuable and we will use your information to improve the services we provide.

All information you provide in this survey is completely confidential and will not be linked to your name or other identifying information.
1. When was your initial First Breath training? (choose one) *This question is required.
2. Which statement best describes you? (choose one) *This question is required.
3. How often do you use the 5 A’s with your clients who use tobacco? (choose one) *This question is required.
4. How confident are you in your ability to implement First Breath? (choose one) *This question is required.
5. If you did not rate "Very confident" or "Completely confident" for question 4, what would need to happen for you to get closer to that rating? (Choose all that apply)