BHAW IOOV Evaluation NSP 3005 IOOV Date of Presentation*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Location of Presentation (city and state):*NAMI Affiliate:*Names of presenters:*How strongly do you agree or disagree with these statements?*Strongly disagreeDisagreeNeutralAgreeStrongly agreeI am familiar with the warning signs for mental health conditionsI believe that recovery from mental illness is possibleI have little in common with people who suffer from mental health conditionsI learned information that is helpful for meThe presenters communicated wellI would recommend this presentation to othersIn you own words, what information was most helpful to you?*In your own words, please describe the top three actions you plan to take that will help yourself or others who struggle with mental health challenges. (Click + to add lines)* Demographics (Optional)GenderFemaleMaleGender fluidPrefer not to answerAre you of Hispanic, Latino, or Spanish origin?NoYesPrefer not to answerWhat is your race? Asian/ Pacific Islander Black/ African American Caucasian Native American/ Alaska Native Multiracial Other Prefer not to answer Please let us know if you are interested in having NAMI contact you for any of the reasons below.* I'm willing to answer some follow up questions about what I learned from the IOOV presentation I'd like to receive more information about NAMI I'm interested in volunteering for NAMI I'd like to be contacted for another reason I prefer not be contacted Name* First Last PhoneEmail Consent I am willing to have my responses and comments used anonymously for research and marketing purposes.