Texas AHEC East Core Program Activities Participant Follow Up

Survey Overview

As part of its ongoing program planning and evaluation process, Texas AHEC East is following up on former participants to learn how they are progressing in their education or career. We would greatly appreciate your feedback. The information collected will help us determine our program effectiveness and will be used internally for planning.

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* 1. Which Texas AHEC East Regional Center's have you participated with?

Capital Region

Coastal Region

DFW Region

Greater Houston Region

North Central Region (formerly Praire AHEC, Weatherford, TX)

Northeast Region (formerly Lake Country AHEC, Tyler, TX)

Piney Woods Region (formerly Piney Woods AHEC, Nacogdoches, TX)

Victoria Region (formerly Pecan Valley AHEC, Victoria, TX)

Waco Region (formerly Brazos AHEC, Waco, TX)

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* 2. Our funding agencies expect us to be able to track participants in order to determine the effect of AHEC activities on career choice. While not required, the following information will greatly assist AHEC in meeting its reporting requirements. We will not share this information outside of Texas AHEC East.

Name

Birthday

Race/Ethnicity

Mailing Address

City

State

Zip

Phone

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* 3. What is the best way to keep in touch with you to follow up on your health career progress?

Facebook

Phone

Mail

Other Social Networking Sites:

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* 4. How influential has AHEC been in your career or education path?

Very Influential

Somewhat Influential

Not Influential at all

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* 5. Please share with us how AHEC has helped you or made a difference in your career path or life.

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* 6. Would you be willing to share your story with others in support of AHEC activities?

Yes