Form Test

  • 1. Trainee Name

  • 2. Training Date

  • MM slash DD slash YYYY
  • 3. Trainee Organization Name

  • 4. Trainee's Organization Type

  • 5. Location of Training

  • Here are some statements about dementia.
    Please read each statement carefully and choose a response to show if you agree or disagree with the statement, or if you don’t know.
    It is important to choose one response (yes, no, or don’t know) for every statement.

  • 6. Respond True, False, or Don't Know to the following items.

  • 7. Use the rating scale from Strongly Agree to Strongly Disagree to respond to the following items