Questionnaire summary:

My Baby's Brain Strand A / Strand B / Deep dive registration

1. Your role

1. Organisation name: [Free text]
2. Organisation team name: [Free text]
3. Role:
   Options [single selection]: Social worker | Health visitor | Family Centre Worker | Other
4. If 'Other', please provide your job role: [Free text]

2. Your eligibility

1. Do you work face to face with parents of young children (0-3) within Hertfordshire?
   Options [single selection]: Yes | No
2. If 'No' please provide your reason for attending. [Free text]
3. Do you work with families predominantly in...
   Options [single selection]: Universal services | Targeted services | Specialist & safeguarding services
4. In which district(s) do you currently work?
   Options [multiple selection]: Broxbourne Borough | Dacorum Borough | East Herts District | Hertsmere Borough | North Herts District | St Albans City and District | Stevenage Borough | Three Rivers District | Watford Borough | Welwyn Hatfield Borough | County-wide
5. Have you previously attended 'My Baby's Brain' training?
   Options [single selection]: Yes | No
6. If so, when did you attend? [Free text]
   A rough month/year answer is fine but please be as specific as you can
7. Please provide additional supporting comments to ensure you are suitable to attend this training. [Free text]