Learning Objectives: Define the term mental illness List at least two symptoms of depression Define the HRSA quality measure for depression screening Understand at least one barrier in the control of diabetes and depression You must have JavaScript enabled to use this form. 1. Did the training meet all of the learning objectives listed above? Yes, the training met all of the learning objectives The training mostly met the learning objectives The training somewhat met the learning objectives The training did not meet the learning objectives 7. How helpful was the information learned today in enhancing the performance and operations of your health center? The information learned today was extremely helpful The information learned today was mostly helpful The information learned today was somewhat helpful The information learned today was not helpful Not applicable (N/A) 8. Was the content balanced and free of commercial bias? Yes No 9. Did the speaker(s) fully disclose any conflict of interest and discussion of off-label usage of medication and/or medical devices? Yes No 10. Please list at least one concept, idea, material or information you learned and believe you will be able to implement in your day-to-day work 11. What is the biggest challenge faced by your health center/clinic in providing quality care for your patients? 12. Do you, or your health center need any additional training or access to specific resources? If so, please specify 13. Additional Comments 14. Did you view this webinar as a individual or in a group? Individual Group 15. If you were in a group, please list the individuals in your group (do not include yourself) 16. Type of Continuing Education certificate you would like to receive? CHW (for Texas participants only) Continuing Nursing Eduation (CNE) Certificate of Attendance 17. If you want to recieve a CHW certificate, please provide your liicense number below It is important that these numbers are provided as they are required by the state for reporting purposes. 19. Name (as it should appear on your certificate) 20. Age 21. Gender Female Male 22. Organization Affiliation 23. Title 24. Mailing Address 25. City 26. State 27. Zip Code 28. E-Mail Address 29. Phone Number 30. Please indicate the type of phone number you provided Home Cell Work