FIDELITY MONITORING LOGCHAPTER 6

For each of the activities listed below, indicate whether you did the activity. YES NO

1. Question box □ □2. Teen pregnancy role play (role play) □ □3. Teen at risk for HIV (discussion) □ □4. Discussion about condoms □ □

How interested were participants in each of the following activities? (Check the box )

Very Interested Interested

A little interested

Not at all interested

1. Question box □ □ □ □2. Teen pregnancy role play □ □ □ □3. Teen at risk for HIV (discussion) □ □ □ □4. Discussion about condoms □ □ □ □

Describe any adaptations that you made to the activities:

1. Question box

2. Teen pregnancy role play

3. Teen at risk for HIV

4. Discussion about condoms

Do you have any suggestions about ways to improve any of the activities?

Name:

Club/Unit:

Date:

FAX completed log to Kirsten Black at: 303-724-1474