C-Care Evaluation Form
Evergreen values your feedback as participants of the C-Care Cancer Support Group. The answers you provide will be used to maintain quality, improve service and support your overall satisfaction. This is an anonymous questionnaire. Please do not put your name on it. Thank you in advance.
Please check the number that best matches how you feel:
(1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree)
Which group did you attend? *
Group Facilitator(s): *
Your answer
Date of last session attended: *
The facilitator(s) was friendly, helpful, respectful, caring and positive.
The facilitator(s) was prepared, and delivers the program topics well.
The facilitator(s) encouraged participation and group cohesion.
It is helpful that the facilitator(s) has first-hand experience with cancer.
I liked meeting in a community space rather than a medical facility.
I learned information, tools and skills to help with cancer related issues.
I developed a connection with the people in the group and ideas that could help me in the future.
As a result of participating in the program, I might call my doctor less for non-medical appointments support.
My experience may lead me to call Evergreen in the future for support.
I would recommend this program to others.
What did you like most about the group?
Your answer
What would you like to learn more about?
Your answer
Additional comments and suggestions?
Your answer
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