Mod01-EHLR Basic Engaging with Your Community Knowledge Assessment

Att4a-Mod01EHLRBasic (Word) RSTw-Chg.docx

[ATSDR] Assessment of Environmental Health and Land Reuse Certification Training

Mod01-EHLR Basic Engaging with Your Community Knowledge Assessment

OMB: 0923-0060

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Mod01-EHLR Basic Engaging with Your Community Knowledge Assessment

Please complete the survey below. Thank you!

Page 1


Form Approved OMB No. 0923-0060

Exp. Date 08/31/2022


ATSDR estimates the average public reporting burden of this collection of information as 5 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office; 1600 Clifton Road NE, MS H21-8 Atlanta, Georgia 30333; ATTN: PRA (0923-0060).


  1. My job title is:

Environmental Health Professional Environmental Professional

Shape4 Tribal Environmental Specialist Planner

Municipal/Tribal Agency Official Developer

Environmental Non-profit/Non-profit Citizen/community member

Student in public health, environmental science, planning, "STEM" discipline

Shape5 None of the above


  1. In reference to the Engaging with Your Community module, please choose all that apply:

Specifically useful for my work. If so, you can describe how below (optional)

Shape7 Shape8 Quick refresher

Offers me knowledge about a topic I am less familiar with

Shape9 Gives me confidence to increase my skills in and understanding of community engagement related to land reuse sites

Shape10 Motivates me to learn more about land reuse sites and ways I can be engaged

Shape11 Not needed for my work None of the above Other (please specify)



  1. If you selected "specifically useful for my work," above, please feel free to describe how here:

Shape13


  1. If you selected "Other," above, please specify here:


Shape15





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