PRE-COURSE SURVEY

Description: This pre-survey is evaluating your use and perception of telehealth since completing the previous certification course. 

Instructions:There are no right or wrong answers. Please indicate your personal belief about each statement below by making the number that best describes you. Be sure to describe your belief as it really is, not as you would like for it to be.  You must complete this survey before you begin reviewing the education content. 

Please create a 4-digit unique random numeric ID that you will utilize as your Student ID for this experience using the following guidelines:

Last digit in your Phone Number (cell or home) – Example: Cell Phone # is 757-123-4567. In this case, digit would be “7”
(1) ________________________________________________

Last Digit in your Birth Year – Example: Birth Year is 2016. In this case, digit would be “6”
(2) ________________________________________________

Last Digit in your Home Street Address – Example: 1234 Anywhere Street – In this case, digit would be: “4”
(3) ________________________________________________

Last Digit in your SSN – Example: 123-45-6789. In this case, digit would be: “9”
(4) ________________________________________________