Follow-up Consent Form

MHFA/YMHFA Trainee Survey (Follow Up Survey)
1. Welcome to the MHFA/YMHFA Trainee Survey
Mental Health First Aid/Youth Mental Health First Aid (MHFA/YMHFA) is an important component in several grant programs funded by the
Substance Abuse and Mental Health Services Administration (SAMHSA) to increase mental health literacy. This survey is administered as
part of a cross-site evaluation conducted on behalf of SAMHSA by the American Institutes for Research (AIR), a private, nonprofit research 
organization. The survey includes questions about mental health literacy and related behaviors that MHFA/YMHFA trainees may engage in
(e.g., encouraing referrals).  
You are being invited to take this survey as part of this study. You already completed a pre- and post-training survey, and you are now being
asked to complete either a three-month or six-month follow-up. We will use the data we collect to better understand how mental health literacy
and associated behaviors may change subsequent to participation in MHFA/YMHFA training. This information will, in turn, be used by SAMHSA to
make data-informed decisions about MHFA/YMHFA in future grant opportunities.
Participation is voluntary and you may stop at any time without penalty. It generally takes 10 minutes to complete this survey.  

All of your responses will be confidential. Your responses will be combined with others’ to learn more about how MHFA/YMHFA is best
implemented in district, school, or other community-based sites.
If you have questions about the evaluation or the survey, you may contact Kimberly Kendziora at [email protected] or (202) 403-5391. If you 
have any questions about your rights as a research participant, you may contact AIR’s Institutional Review Board at [email protected], or toll free at 
1­800­634­0797.

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1. Do you agree to have your confidential responses included in this study?

j Yes, I agree to have my responses included in the study.
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j No, I do not wish to be included in this study.
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