It's Your Right to Know! Helping Community Health Workers Promote Chemical Safety on the Job

Learning Objectives:

1. Recognize how workers are exposed to chemicals on the job and the health effects. 2. Describe basic safety practices when working around chemicals. 3. Understand the role of Community Health Workers in helping workers prevent chemical exposure.

1 - The learning objectives were not met 2 - The learning objectives were somewhat met 3 - The learning objectives were mostly met 4 - The learning objectives were completely met.

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1 - Poor 2 - Slight 3 - Moderate 4 - Excellent

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1 - Dissatisfied 2 - Somewhat satisfied 3 - Mostly satisfied 4 - Completely satisfied

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1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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N/A - Not applicable 1 - Not at all helpful 2 - Somewhat helpful 3 - Mostly helpful 4 - Completely helpful

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1 - Not at all important 2 - Somewhat important 3 - For the most part important 4 - Completely important

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If this does not apply to you, please enter "N/A" in the box below.

CERTIFICATES FOR THIS TRAINING WILL BE SENT ELECTRONICALLY. IF YOU WISH TO RECEIVE A HARD-COPY OF YOUR CERTIFICATE, PLEASE MAKE SURE TO FILL IN ALL APPROPRIATE FIELDS BELOW.

1 - PCA 2 - Community Organizaiton 3 - Health Center 4 - HCCN (Health Center Controlled Network) 5 - State agency 6 - Federal agency 7 - Other / Not included in this list 8 - I'm not sure / Don't know

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NOTE: ONLY CERTIFICATES OF ATTENDANCE WILL BE ISSUED FOR PARTICIPATING IN THIS TRAINING. 1 - Continuing Medical Education (CME) 2 - Continuing Nursing Education (CNE) 3 - Texas CHW Certificate 4 - Certificate of Attendance

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Please enter your phone number in one of the following formats: xxx - xxx - xxxx OR (xxx) xxx - xxxx

1 - Cell/ Mobile 2 - Home 3 - Work/Office

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