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First name:

Last name:

Email address:

Organization/Agency name:

After this workshop, how do you rate your knowledge about:

***After this workshop, how do you rate your knowledge about:***
	Low	Medium	High
The importance of identifying and addressing adverse childhood experiences (ACEs)	Low	Medium	High
ACEs’ impacts on brains and behavior	Low	Medium	High
How ACEs may have impacted your own life or your family’s	Low	Medium	High
My ability to teach others what I have learned about ACEs	Low	Medium	High
The role of ACEs in my job	Low	Medium	High
ACEs’ implications for the organization that employs me.	Low	Medium	High
Why and how my community needs to get organized and mobilized to identify and address ACEs	Low	Medium	High
What it takes to develop a community-wide, trauma-informed system	Low	Medium	High

As a result of this training, will you:

As a result of this training, will you:
	No	Maybe	Yes	Already doing this
Incorporate ACEs’ assessment and treatment in your daily work?	No	Maybe	Yes	Already doing this
Seek more information about the causes and effects of ACEs?	No	Maybe	Yes	Already doing this
Seek more information and guidance regarding trauma-informed practice?	No	Maybe	Yes	Already doing this
Advocate for ACEs assessments and treatments as a permanent fixture in your organization?	No	Maybe	Yes	Already doing this
Actively participate in community-wide efforts to identify, assess, and treat ACEs’ victims.	No	Maybe	Yes	Already doing this

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