Seizure Smart Trainings Evaluation Form

First Name

Last Name

Phone

Zip Code

What is your relationship to epilepsy?

I have epilepsy/seizuresMy child has epilepsy/seizuresMy parent has epilepsy/seizuresMy spouse or partner has epilepsy/seizuresAnother family member has epilepsy/seizuresA friend/co-worker has epilepsy/seizuresI work with people who have epilepsy/seizuresOther/prefer not to respond

Seizure Smart Trainings Evaluation

Date of Training:

Training Platform:

Training Location:

What Seizure Smart Training did you participate in?

	Agree	Somewhat Agree	Neutral	Somewhat Disagree	Disagree
My knowledge of epilepsy and seizures increased.
I am able to recognize various seizure types.
I learned how to respond to seizures.
I gained a better understanding of the variety of ways epilepsy can impact a person's life.
I gained a better understanding of the steps taken to create safe spaces for people with epilepsy.

Please add any comments from your answers above:

Please specify:

Are you aware of another organization who would benefit from this training?

YesNo

If yes, who?

How did you hear about Seizure Smart Trainings?

Please specify:

Contact Information

Employment Services

Employment services are available to employers, employees, and those seeking employment. We help educate and create a supportive working environment through free trainings, workshops, and individual consultations.

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