Consent Awareness Feedback Form
Help us assess your understanding of consent and provide feedback on our consent awareness program.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
What is your age group?
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55+
Have you previously attended a consent awareness session or training?
*
Yes
No
How would you rate your understanding of the concept of consent before participating in this program?
*
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
How would you rate your understanding of the concept of consent after participating in this program?
*
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
Which of the following statements best describes consent?
*
Consent is a one-time agreement that does not need to be renewed.
Consent is ongoing and can be withdrawn at any time.
Consent is only needed for certain situations.
Other (please specify)
Please indicate your level of agreement with the following statements about consent.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Consent must be clear and enthusiastic.
1
2
3
4
5
Consent can be withdrawn at any time.
6
7
8
9
10
Assuming consent is not acceptable.
11
12
13
14
15
Consent is necessary in all interactions.
16
17
18
19
20
In which situations do you think consent is required? (Select all that apply)
*
Physical contact
Sharing personal information
Taking or sharing photos/videos
Participating in activities
Other
How effective was the consent awareness program in increasing your understanding?
*
1
2
3
4
5
What suggestions do you have to improve future consent awareness programs?
Submit Feedback
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