Someone You Love - The HPV Epidemic Organizer's Survey

Toolkits help us navigate the complexities in modern healthcare

Someone You Love - The HPV Epidemic Organizer’s Evaluation for Group Screenings

Thank you for showing this powerful film about HPV / Cervical Cancer in your community! We hope that your attendees will share the stories of the young women showcased in the film, underscoring the importance of preventing HPV disease through immunization!

Please tell us about your film screening:

1. Location of the film showing

2. County

3. Film screening sponsored/organized by:

4. Number of attendees at the film screening

Females

Males

5. Average age of attendees who viewed the film

6. Did you use the recommended anonymous evaluation survey? Yes No

7. Did you promote continuing education credits? Yes No

8. Did you offer a panel discussion after the film? Yes No

If yes please provide names of the panel experts:

9. General comments about reaction to the film, organizing the film screening or technical issues.