{"id":8381,"date":"2021-07-01T10:54:12","date_gmt":"2021-07-01T17:54:12","guid":{"rendered":"https:\/\/www.palomar.edu\/pages\/healthpromotion\/?page_id=8381"},"modified":"2021-07-01T10:54:12","modified_gmt":"2021-07-01T17:54:12","slug":"evaluation-form","status":"publish","type":"page","link":"https:\/\/www.palomar.edu\/healthpromotion\/evaluation-form\/","title":{"rendered":"Evaluation Form"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_4' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'>Thank you for attending a wellness event\/presentation. Your opinions are very important to us. Please complete our brief survey to tell us about your experience. We appreciate your time for completing our survey!<\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/healthpromotion\/wp-json\/wp\/v2\/pages\/8381' data-formid='4' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_4_25\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_25'>Student ID#:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_4_25' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_24\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_24'>Presenter(s)<\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_4_24' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_27\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Presentation Topic<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_27'><div class='gchoice gchoice_4_27_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.1' type='checkbox'  value='Department Services &amp; Resources'  id='choice_4_27_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_1' id='label_4_27_1' class='gform-field-label gform-field-label--type-inline'>Department Services &amp; Resources<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.2' type='checkbox'  value='Narcan Training'  id='choice_4_27_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_2' id='label_4_27_2' class='gform-field-label gform-field-label--type-inline'>Narcan Training<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.3' type='checkbox'  value='Skillshop: Mindfulness, Meditation &amp; Relaxation'  id='choice_4_27_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_3' id='label_4_27_3' class='gform-field-label gform-field-label--type-inline'>Skillshop: Mindfulness, Meditation &amp; Relaxation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.4' type='checkbox'  value='Skillshop: Healthy Relationships'  id='choice_4_27_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_4' id='label_4_27_4' class='gform-field-label gform-field-label--type-inline'>Skillshop: Healthy Relationships<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.5' type='checkbox'  value='Skillshop: Healthy Sleep'  id='choice_4_27_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_5' id='label_4_27_5' class='gform-field-label gform-field-label--type-inline'>Skillshop: Healthy Sleep<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.6' type='checkbox'  value='Skillshop: Stress Management'  id='choice_4_27_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_6' id='label_4_27_6' class='gform-field-label gform-field-label--type-inline'>Skillshop: Stress Management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.7' type='checkbox'  value='Skillshop: Understanding Depression &amp; Suicide'  id='choice_4_27_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_7' id='label_4_27_7' class='gform-field-label gform-field-label--type-inline'>Skillshop: Understanding Depression &amp; Suicide<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.8' type='checkbox'  value='Skillshop: Mindfulness through Vision Boards'  id='choice_4_27_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_8' id='label_4_27_8' class='gform-field-label gform-field-label--type-inline'>Skillshop: Mindfulness through Vision Boards<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_27_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.9' type='checkbox'  value='Other'  id='choice_4_27_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_27_9' id='label_4_27_9' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_23\" class=\"gfield gfield--type-survey gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_23'>Other Presentation Topic<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_4_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How did you hear about this event\/presentation?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox gfield_choice--select_all_enabled' id='input_4_28'><div class='gchoice gchoice_4_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Palomar Promise Program'  id='choice_4_28_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_1' id='label_4_28_1' class='gform-field-label gform-field-label--type-inline'>Palomar Promise Program<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='E-Mail Announcement'  id='choice_4_28_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_2' id='label_4_28_2' class='gform-field-label gform-field-label--type-inline'>E-Mail Announcement<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_28_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.3' type='checkbox'  value='Social Media'  id='choice_4_28_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_3' id='label_4_28_3' class='gform-field-label gform-field-label--type-inline'>Social Media<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_28_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.4' type='checkbox'  value='Website'  id='choice_4_28_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_4' id='label_4_28_4' class='gform-field-label gform-field-label--type-inline'>Website<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_28_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.5' type='checkbox'  value='Flyer around Campus'  id='choice_4_28_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_5' id='label_4_28_5' class='gform-field-label gform-field-label--type-inline'>Flyer around Campus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_28_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.6' type='checkbox'  value='Word of Mouth (Student\/Professor\/Staff)'  id='choice_4_28_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_6' id='label_4_28_6' class='gform-field-label gform-field-label--type-inline'>Word of Mouth (Student\/Professor\/Staff)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_28_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.7' type='checkbox'  value='Other'  id='choice_4_28_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_28_7' id='label_4_28_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gfield-choice-toggle-all\"><button type=\"button\" id=\"button_28_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/div><\/fieldset><div id=\"field_4_16\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Please rate the quality of the presentation you received:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='Please rate the quality of the presentation you received:' class='gsurvey-likert' id='input_4_16'><thead><tr><th id='likert_col_1_4_16' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Excellent<\/th><th id='likert_col_2_4_16' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Good<\/th><th id='likert_col_3_4_16' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Average<\/th><th id='likert_col_4_4_16' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Poor<\/th><th id='likert_col_5_4_16' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Very Poor<\/th><\/tr><\/thead><tbody><tr><td data-label='Excellent' class='gsurvey-likert-choice'><input name='input_16' type='radio' value='glikertcol161b14b7c9'  id='choice_4_16_1'    aria-labelledby='likert_col_1_4_16'\/><\/td><td data-label='Good' class='gsurvey-likert-choice'><input name='input_16' type='radio' value='glikertcol16db3991a7'  id='choice_4_16_2'    aria-labelledby='likert_col_2_4_16'\/><\/td><td data-label='Average' class='gsurvey-likert-choice'><input name='input_16' type='radio' value='glikertcol16a149e8be'  id='choice_4_16_3'    aria-labelledby='likert_col_3_4_16'\/><\/td><td data-label='Poor' class='gsurvey-likert-choice'><input name='input_16' type='radio' value='glikertcol1630c24dc4'  id='choice_4_16_4'    aria-labelledby='likert_col_4_4_16'\/><\/td><td data-label='Very Poor' class='gsurvey-likert-choice'><input name='input_16' type='radio' value='glikertcol1631e54ca0'  id='choice_4_16_5'    aria-labelledby='likert_col_5_4_16'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_4_17\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >How helpful was the presentation you received?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_likert'><table aria-label='How helpful was the presentation you received?' class='gsurvey-likert' id='input_4_17'><thead><tr><th id='likert_col_1_4_17' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Very helpful<\/th><th id='likert_col_2_4_17' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Somewhat helpful<\/th><th id='likert_col_3_4_17' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Neutral<\/th><th id='likert_col_4_4_17' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Somewhat unhelpful<\/th><th id='likert_col_5_4_17' scope='col' role='presentation' class='gsurvey-likert-choice-label'>Very unhelpful<\/th><\/tr><\/thead><tbody><tr><td data-label='Very helpful' class='gsurvey-likert-choice'><input name='input_17' type='radio' value='glikertcol179b89663b'  id='choice_4_17_1'    aria-labelledby='likert_col_1_4_17'\/><\/td><td data-label='Somewhat helpful' class='gsurvey-likert-choice'><input name='input_17' type='radio' value='glikertcol1751990b99'  id='choice_4_17_2'    aria-labelledby='likert_col_2_4_17'\/><\/td><td data-label='Neutral' class='gsurvey-likert-choice'><input name='input_17' type='radio' value='glikertcol177a4a8ea3'  id='choice_4_17_3'    aria-labelledby='likert_col_3_4_17'\/><\/td><td data-label='Somewhat unhelpful' class='gsurvey-likert-choice'><input name='input_17' type='radio' value='glikertcol177c062083'  id='choice_4_17_4'    aria-labelledby='likert_col_4_4_17'\/><\/td><td data-label='Very unhelpful' class='gsurvey-likert-choice'><input name='input_17' type='radio' value='glikertcol17b3cf7e9a'  id='choice_4_17_5'    aria-labelledby='likert_col_5_4_17'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><div id=\"field_4_20\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_20'>Name one thing you learned from this presentation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_20' id='input_4_20' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_21\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_21'>Name one behavior change you will make after attending this presentation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_4_21' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_22\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_22'>How can you access services offered by the Student Health Centers and Behavioral Health Counseling Services at Palomar College?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_4_22' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_19\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' for='input_4_19'>What would you do to improve this presentation?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_4_19' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_4' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_4' value='postback' \/>\n            <input type='hidden' 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