Help us track the positive impact and reach of the Growing Community DVD series around the state by completing the following:
 
 
 
Name:
 
Email Address:
 
Date of Screening:
 
City/County:
 
Location venue of screening:
 
Number of attendees:
 
 
 
 
Which DVD segments were viewed (pick all that apply):
 
 
 
Target Audience: (Pick all that apply)
 
 
 
After watching the DVD, participants… (Pick all that apply):
 
 
If you selected "Other," please specify:
 
 
 
 
If you would like to leave additional comments, your feedback is always welcome:
 
 
 
 
 
 
 
You will be redirected to the Growing Community homepage upon successful submission of this survey.

Thank you! Your feedback is very important to us.

 
If you have any questions about this survey, please contact Martin Evans at (512)458-7111 (Ext. 3234) or Martin.Evans@dshs.state.tx.us.