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IMPACT SURVEY
Let us know how
helpful this initiative has been for you.
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If you have questions or comments about this initiative, we'd
love to hear from you
.
Location:
Birth Date:
Gender:
Male
Female
Marital Status:
Never Married
Married
Living As Married
Divorced
Separated
Widowed
Number of parents living in household:
1
2
Number of children at home:
None
1
2
3
4
More than 4
Education Level:
Some High School
High School
Grad/GED
Some College
College Graduate
Postgraduate Degree
As a result of attending the "Tell It To me Straight" session, how confident are you that you could have a conversation about sexuality with your teen(s)?
very confident
somewhat confident
slightly confident
not confident at all
Have you employed a new approach to the conversation of sexuality with your teen(s)?
yes
no
Have you had a conversation with your teen(s) about sexuality since attending the "Tell It To Me Straight" session?
yes
no
As a result of attending the session, how confident are you that you could have a conversation about internet usage with your teen(s)?
very confident
somewhat confident
slightly confident
not confident at all
Have you had a conversation with your teen(s) about internet usage since attending the "Tell it To Me Straight" session?
yes
no
Have you had a conversation with your teen(s) about internet reality vs. fantasy since attending the "Tell it To Me Straight" session?
yes
no
Have you had a conversation with your teen(s) about family values and the internet since attending the "Tell It To Me Straight" session?
yes
no
What skills (i.e., knowledge, information, techniques, etc.) did you learn specifically from the high school teens for talking to your own teen(s)?