2. Living Well With Lewy Body Dementia Evaluation
4. Which of the following describes you (please check all that apply):

   1. Person with Lewy Body Dementia (LBD) or other related dementia
   2. Caregiver of someone with LBD or other related dementia
   3. Family member of someone with LBD or other related dementia
   4. Friend of someone with LBD or other related dementia
   5. Interested community member
   6. Healthcare Professional
   7. Research Professional
   8. Student
   9. Not Applicable
6. Sex

   1. Male
   2. Female
   3. Other
   4. Prefer not to answer
7. Age

   1. 18 - 29
   2. 30 - 39
   3. 40 - 49
   4. 50 - 59
   5. 60 - 69
   6. 70 - 79
   7. 80 or older
9. Highest Level of Education Completed

   1. Middle School
   2. High School/GED
   3. Some College
   4. Vocational Training/Trade School
   5. College Degree
   6. Master's Degree
   7. Professional Degree (PhD, MD, DVM, DDS, JD, etc.)
10. Race You Identify As

    1. African American/Black
    2. Asian
    3. Caucasian/White
    4. Hispanic or Latino
    5. Mixed/Bi-racial
    6. Native American
    7. Pacific Islander
    8. Other
12. Overall rating of the program

    1. Excellent
    2. Good
    3. Neutral
    4. Poor
    5. Very Poor
    6. Did Not Attend
14. Overall rating of the SPARK film

    1. Excellent
    2. Good
    3. Neutral
    4. Poor
    5. Very Poor
    6. Did Not Attend
16. Degree to which the program met your needs

    1. Excellent
    2. Good
    3. Neutral
    4. Poor
    5. Very Poor
    6. Did Not Attend
18. Overall knowledge and quality of presenters

    1. Excellent
    2. Good
    3. Neutral
    4. Poor
    5. Very Poor
    6. Did Not Attend
20. Overall value and importance of the content offered

    1. Excellent
    2. Good
    3. Neutral
    4. Poor
    5. Very Poor
    6. Did Not Attend
22. Satisfaction with discussion and opportunities for questions

    1. Excellent
    2. Good
    3. Neutral
    4. Poor
    5. Very Poor
    6. Did Not Attend
24. The information presented today increased my understanding of Lewy Body Dementia

    1. Strongly Agree
    2. Agree
    3. Neutral
    4. Disagree
    5. Strongly Disagree
26. My knowledge of resources about Lewy Body Dementia was improved

    1. Strongly Agree
    2. Agree
    3. Neutral
    4. Disagree
    5. Strongly Disagree
28. I would recommend others attend this presentation

    1. Strongly Agree
    2. Agree
    3. Neutral
    4. Disagree
    5. Strongly Disagree
30. What was most beneficial about the event?
32. What was least beneficial about the event?
34. What language do you speak most often or feel most comfortable speaking and reading?
36. How did you learn about the event?
37. Have you attended an in-person or virtual event on Lewy body dementia in the past?

    1. Yes
    2. No
39. Why did you participate in this event?
41. What LBDA resources, educational interventions, and/or collaboration would be helpful for you?
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43. 1. Receive an email copy of this form.
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