The document is a survey from the American Red Cross about a healthcare or public safety training experience. It asks questions to gather information about the type of training completed, such as basic life support, CPR, or first aid. It also collects feedback on the instructor's performance and the overall experience through questions that are rated on scales or can be answered with options provided. The purpose is to evaluate the training for quality improvement purposes.

1. Healthcare and Public Safety Training
TheAm-,RedCross is••BSllldin IN11i,gabout)'Ot6lrairliige,tpe,ienoe. Pllaase.,_, usbyaasqa119 fie
followaigque,rans.
Your nslrudorshouldhaveprov,dedinfonnationfor
0ueswns1-2.
Ifnot planego<ill!ldlytoQuaswn3 .
1. Four�lorahancode
_7__o__•__o_
2. Cotneoffemgcode
ll £.SB. 1'..S. l.. Cl-1
4 . "*=!,eot.ne(s)are youevaklatingIOday?
(Chedcalllaf8')ply)
� 8a9icUeSupportforI leallhcaePn:!Ydefs
D CPR/AEDforP,ofessi..... R8SaJel'Sand
Ileallhcare Provldals
0 EmergancyMt:tica!Ra�(EMR)
D M11ns111ting EITlelg8rlCfOxygen
0 Olhar,pie edarccba...::.:.:.......::...____
5 . DatelZ.e
!"!5
co,r,plefed(WOOIYYYY)
lo li2!l!Sl
6 Have)'OUtalcenhstn,ed11aili,g bebemmfieRed
Crossaanotherogalizallcn? (Checkcnyone}
� Yes masl ,eca.iytran RadCross
0 Yes, mostr-lllyfrornanotwagaiizai11
D No
7. Whaloommen&s�youIketosha"e abo.ths
baiiq?
Vu e.D/t.pR- ��uz..
8. Ooyou�'h!ie.,.-,c:llhisausetobe<.
D Toostm �.l.tstllf1' 0 ToobV
9 . WhlllbastdesatlasyoAJ1posiion?(Chedtalthataq>ly)
0 PLfllic Safety(i.e. rn Police, EMS)
� lleall1C«a(i.e.. Physician. Nine. Phauuarist.
Denlisl)
0 hpldlics{ia�Iiegl�WallerSali!tylnstru:::la-)
D Other-.pleasespecly________
10. 'IMlalISOfdbe yoAJ1pc,&),oofL8. Par.medic. Nl.nng
Sludanl
)
�
��
0 Yes � No
12 Did)'OUhawmotelhanone inslrudorfayoAJ1class? 0 Yes
13. °"8rall, towwouldyourateht
i'lAtJdor(s)l18t� )"!Urclass?
&c1l1nt
0
v.,,,
-k
-. "-
0 a a
lhad
-------l>ef
--ED ....... __,
0 0
14 Wot*!)'OUbewdingto allowtheAmerica, RadCrosstofolowt.pWllhyoureoa,diu)'OtJo'WISlrl.arerlranrig
expeiiance?(Nole: WeurlortlS'lalel)'may not be abletofolowupwllh�)
ji( Yes O No
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