Day of Service Data Forms

The following forms are a critical component to the evaluation of the A.T.T.A.C. Program.  All of these forms are required as part of participation in the program.  To receive complete credit for your participation you must turn in all of the forms in a timely manner. 

Headcount Form (1 per team) – Use this form to record the number of middle school students in each of the class periods to which you present.

Middle School Student Surveys (1 per middle school student) – Collect these from the middle school students at the end of each class period. 

Team Evaluation Form (1 per team) – Provide this to each teacher when you arrive in the classroom.  An envelope has been provided in your toolbox kit so that the teacher can complete the form and seal it in the envelope before returning it to you.  It is your responsibility, not the teachers, to ensure that this form is completed and submitted to GSAHEC. 

All of these forms are provided in hard copy format during the Training Session and in the Toolbox Kits you will take to the Day of Service.  If you have any questions, please contact Emily Hite, Tobacco Training Coordinator, at ehite@health.usf.edu.

 

 

Sponsored by Gulfcoast South AHEC and the State of Florida, Department of Health.

 


 

For more information about A.T.T.A.C. please contact:

Emily M. Hite
Tobacco Training Coordinator
ehite@health.usf.edu

Tiffany Prater, MA
Clinical Training Coordinator
tprater@health.usf.edu

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