First Aid and CPR Training (FY09) The American Red Cross is interested in learning about your experience with First Aid and CPR training. Please help us by answering the following questions. Questions marked with an asterisk (*) are required. 1. Please enter the survey code (chapter code) given when you were invited to complete this survey: 32400 2. Instructor’s full name: General Information 3. Which of the following courses are you evaluating today? o First Aid o Adult CPR o Infant and Child CPR o CPR for the Professional Rescuer o Other (please specify) _________________ 4. How many times have you taken this course? o This is my first time o This is my second time o This is my third time o More than 3 times 5. Did you take this course for re-certification? ○ Yes ○ No 6. Did you need certification for a job, school, a volunteer position, or another requirement? ○ Yes ○ No 7. Have you taken other Red Cross courses before? ○ Yes ○ No 8. The cost of this course is: o Just right o Expensive o Inexpensive o Did not pay 9. If you did not pay, select the appropriate option: o My employer paid o This course was free of charge o I am not sure who paid o Other, please specify _______________ 10. You consider the length of this course to be: o Just right o Too long o Too short 11. Did you complete the knowledge portion of your course using Web based (computer) technology? ○ Yes ○ No 12. Are you interested in using computer-based learning as part of your Red Cross course in the future? ○ Yes ○ No ____________________________________________ About the services you received 13. Thinking about your experience with this Red Cross course, on a scale from 1 to 6 (with 1 being extremely poor and 6 being excellent), please rate each of the following by selecting the number that best represents your opinion. 6 Excellent Instructor’s ability to present information clearly Instructor’s knowledge: ability to answer questions Inclusion of skills and information that you needed Quality of course books and videos Effectiveness in helping you learn skills Availability/courtesy of Red Cross staff to answer questions Convenience of the times offered in the course schedule Convenience of the course locations Overall satisfaction with this Red Cross Course 5 Good 4 Above Average 3 Below Average 2 Poor 1 Does Not Extremely Apply Poor ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ Ease of course registration 14. Thinking about the skills you learned today, please select the number that best represents how you closely each of the following statements describes how you feel. 6 Strongly Agree 5 Agree 4 Tend to Agree 3 Tend to Disagree 2 Disagree 1 Strongly Disagree Does Not Apply I feel confident that I know how to identify an emergency situation I feel prepared to respond to an emergency Should an emergency arise, I am willing to provide emergency care using the skills I learned today I am comfortable emergency responding to an ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ I would recommend this Red Cross Course to a friend. About Yourself The Red Cross wants to know more about you and your specific needs to better tailor our programs and services to our communities. Please provide us with the following information. 15. You are: ○ Male ○Female 17. You consider yourself to be: (SELECT ONLY ONE) o Hispanic or Latino (of any race) o White (Not Hispanic or Latino) o Black or African American o Asian (Not Hispanic or Latino) o Native Hawaiian or other Pacific Islander (Not Hispanic or Latino) o American Indian or Alaskan Native (Not Hispanic or Latino) o Two or more races (Not Hispanic or Latino) o Other (please specify) __________________________________ 18. Age Group: ○ 12 or younger ○ 13 to 18 ○ 19 to 25 ○ 26 to 40 ○ 41 to 55 ○ 56 or older 19. Your ZIP code: 20. Date of training 16. How did you first learn about this Red Cross Presentation? o A Red Cross campaign for disaster/emergency preparedness, such as “Be Red Cross Ready” o Red Cross ad on TV/radio o Printed material o Browsing the Red Cross Web Site o From the Federal Government o From a Red Cross worker o From a friend/family member o At work o At School o From a social Service organization o Other (please specify) ____________________________________ 21. Please use this space to let us know what you liked best about this training, and any suggestions you might have for improvement.
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