Post Module Survey

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Review your experience with the resources provided through this initiative.
After completion of the survey, you will have access to our Facilitator’s Guide.

Submit a Post Module Survey

Your responses to all questionnaires and surveys are anonymous. Identifiers that link responses to individual participants will not be collected unless participants voluntarily provide their contact information for future correspondence with the website contributors.

Post Module Survey

How do you plan to utilize the tools provided on this website? (select all that apply) *

Personal use to address encounters marked by bias

Support a colleague or trainee

To teach others

OtherOther

Age *

What racial group(s) describe you? (select all that apply) *

American Indian or Native Alaskan

Asian

Black or African American

Middle Eastern or North African Descent

Native Hawaiian or Other Pacific Islander

White

I prefer not to answer

OtherOther

What ethnic group describes you? *

What is your gender identity? (select all that apply) *

Agender

Genderqueer or genderfluid

Man

Nonbinary

Questioning or unsure

Transgender

Woman

I prefer not to answer

OtherOther

Which of the following best represent how you think of yourself? * Which of the following best represent how you think of yourself?

Current Professional Role: * Current Professional Role:

After completing the module(s), I feel prepared to directly respond to the individual(s) who displayed a biased behavior towards me. *

After completing the module(s), I feel prepared to directly respond to the individual(s) who displayed a biased behavior towards others. *

I would recommend this website to others. *

Additional comments that you would like to share:

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Post Module Survey

Survey

Review your experience with the resources provided through this initiative. After completion of the survey, you will have access to our Facilitator’s Guide.

Submit a Post Module Survey

Want More Reading and Video Resources?

Review your experience with the resources provided through this initiative.
After completion of the survey, you will have access to our Facilitator’s Guide.