Dementia Friends Pre-test There are more than 230,000 Dementia Friends across the country! Email(Required) (We will not share this email-this allows us to compare pre and post-test):City(Required)State(Required) AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Enter your state Zip Code(Sharing your ZIP code helps us credit your community. This question is optional.)What is/ are your personal experiences with dementia: (check all that apply)(Required) I am living with dementia. I am or have been a care partner for someone who is living with dementia. I am a professional who works with people living with dementia. I know someone who is living with dementia. I do not have any experience with anyone living with dementia but want to learn more about it. Please select true or false for the follow statements below: Dementia is a typical/ normal part of aging.(Required)SelectTrueFalseDementia is caused by diseases of the brain.(Required)SelectTrueFalseDementia is not just about having memory problems. It may affect thinking, communication, and ability to carry out everyday tasks.(Required)SelectTrueFalseThere are healthy habits you can adopt to reduce your risk of dementia.(Required)SelectTrueFalsePlease select true or false for the follow statements below: I am confident interacting and communicating with people living with dementia.(Required) Strongly Agree Agree Disagree Strongly Disagree It is possible to live well and be engaged with your community with a dementia diagnosis.(Required) Strongly Agree Agree Disagree Strongly Disagree People living with dementia need to feel safe, respected, and included, just like anyone else.(Required) Strongly Agree Agree Disagree Strongly Disagree I am motivated to connect with people living with dementia.(Required) Strongly Agree Agree Disagree Strongly Disagree I am aware of tools and resources in my community to support people living with dementia.(Required) Strongly Agree Agree Disagree Strongly Disagree Please list three words that you associate with the word “dementia.”(Required)What do you hope to learn or gain from this Dementia Friends session?(Required)
