Educator Evaluation Form
USA?
Yes
No
Country
Country Copy
School
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Account ID NOT USA
State
State Copy
School
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Account ID USA
Account ID
Which level of classroom program did you use?
Please select...
Level 1: We All Have Mental Health (Ideal for Grades 4-6)
Level 2: Depression Awareness (Ideal for Grades 5-9)
Level 3: Depression Education & Suicide Awareness (Ideal for Grades 8-12)
Did you complete the 1 day or 3-4 day lesson plans?
Please select...
1 Day
3-4 Day
How many students received the Erika’s Lighthouse program?
Did you distribute the self-referral cards to your students at the end of the lesson(s)?
Please select...
Yes
No
The Erika’s Lighthouse program positively impacted students
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I would recommend this program to other educators
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The Erika’s Lighthouse program was easy to implement
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Erika’s Lighthouse programs promote a positive, inclusive culture in my school environment
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
What are different ways that you would deliver the program materials that might be more beneficial to your students?
Other comments/feedback
Contact Information