A. Firstly, please tell us about yourself

Name

Job Title

Address Line 1

Address Line 2

Town/City

Postcode

Tel

Email

B. About Threadworm Action Week

1. Have you taken part in any of the Threadworm Action initiatives before? Yes No

2. How did you become aware of Threadworm action week?

3. Did you request materials for a specific event? If so was it during Threadworm Action Week? Yes (Before) Yes (During) Yes (After) No

C. Your Threadworm Action Pack

4. What did you find useful from your Threadworm Action Pack?
Please also rate the items in temrs of usefulness (1 being most useful and 5 being least useful)

Items included in the pack:

Handwashing Poster Useful Not useful Rating

Stickers Useful Not useful Rating

Activity Booklet Useful Not useful Rating

Clean Hands Star Chart Useful Not useful Rating

Wet Wipes Useful Not useful Rating

Items not included in the pack (requested separately):

Leaflets, Fact Sheets, Bookmarks Useful Not useful Rating (if applicable)

DVD 'Dealing with Threadworms' Useful Not useful Rating (if applicable)

5. Could you briefly explain how you used the pack?

6. Are there any other items you would have liked to have seen in the pack?

D. Future Initiatives

7. Had you heard of Pripsen before Threadworm Action Week? Yes No

8. Would like to be contacted for Threadworm Action Week 2008? Yes No

9. Do you have any other comments you would like to make?