beneath the surFACE Survey

1. How many students/attendees was the curriculum delivered to? *This question is required. Note: multiple classes or sessions may be combined as long as the number of students/attendees match the scores from assessment materials. This question requires a valid number format.

2. PRE-ASSESSMENT average score. Note: multiple classes or sessions may be combined as long as the scores from assessment materials match the number of students/attendees. This question requires a valid percent format.

3. PRE-PROGRAM survey. Please record the percentage of students/attendees that would consider getting, or have received, the HPV vaccination.
Note: multiple classes or sessions may be combined as long as the scores from assessment materials match the number of students/attendees. This question requires a valid percent format.

4. POST-ASSESSMENT average score. Note: multiple classes or sessions may be combined as long as the scores from assessment materials match the number of students/attendees. This question requires a valid percent format.

5. POST-PROGRAM survey. Please record the percentage of students/attendees that would consider getting, or have received, the HPV vaccination.
Note: multiple classes or sessions may be combined as long as the scores from assessment materials match the number of students/attendees. This question requires a valid percent format.

6. Overall, how would you rate the content and effectiveness of this program? *This question is required.

Space Cell	Rating (1 is low; 5 is high)
Program overall rating	Reset star selection 1 out of 5 stars for Program overall rating: Rating (1 is low; 5 is high) 2 out of 5 stars for Program overall rating: Rating (1 is low; 5 is high) 3 out of 5 stars for Program overall rating: Rating (1 is low; 5 is high) 4 out of 5 stars for Program overall rating: Rating (1 is low; 5 is high) 5 out of 5 stars for Program overall rating: Rating (1 is low; 5 is high)

STATE
COUNTY

8. Please list any additional feedback or comments you might have for improvements or praise on the beneath the surFACE program: