Mandated Reporter Training Survey
Please complete this survey to provide feedback and confirm your understanding after attending the Mandated Reporter Training.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Training Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Training Attended
*
Please Select
In-person
Online/Virtual
Self-paced/Recorded
Other
Trainer's Name (if applicable)
How confident do you feel in recognizing signs of abuse or neglect?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Please rate the overall quality of the training.
*
1
2
3
4
5
Knowledge Assessment: For each scenario, indicate if you would be required to report.
*
Rows
Yes
No
A child discloses physical abuse to you.
1
2
You suspect neglect due to repeated absences.
3
4
You witness a colleague physically disciplining a child.
5
6
You overhear a vague comment about possible abuse.
7
8
You learn of possible abuse from a third party.
9
10
What aspects of the training were most helpful?
What suggestions do you have for improving future trainings?
Submit Survey
Should be Empty: