FALL PREVENTION MONTH: Impact evaluation form
Your feedback is very important to us as we start thinking about Fall Prevention Month 2016. Kindly respond to the questions below, and provide us with any additional comments you may have.
- Fall Prevention Month organizers.
How has a fall affected your life?
Your answer
What is one thing you will change to prevent falls for yourself or someone you know?
Your answer
What is one thing you will do to improve your level of physical activity?
Your answer
Additional comments:
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service