Site Coordinator Questionnaire

HIV Prevention Satellite Broadcast (October 22, 1998)

Please print this form to complete and mail in the envelope that will be provided in your site coordinator packet.

1. Approximately how many people watched the broadcast at your site?

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2. What kind of organization is your viewing site (e.g., local health department)?

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3. How did you learn about the broadcast?

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4. How could we better advertise the broadcasts?

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5. How could the process for registering a viewing site be improved?

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6. How could we improve this experience for your viewers?

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7. Please tell us about anything you did to enhance your viewers' experience, such as conducting a discussion session during the break:

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8. What did you do to advertise the broadcast for viewers?

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9. Any additional recommendations?

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   If we have further questions about the broadcast, may we contact you? If so, please print:

   Name: ___________________________		Organization: ___________________________
   City: ___________________________		State or Territory: ___________________________
   Phone Number: (_______) _________________		E-mail address: ___________________________

   Thank you for your time and feedback!