Program Support Group Evaluation Form
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1
2(Insert Name) PROGRAM
Support Group Evaluation Form
1.
Which face best captures how you feel about this program overall?
(please mark an 'x' over your choice)
L
K
J
K?
What do you like best?
___________________________________________________
___________________________________________________
What do you like least?
___________________________________________________
___________________________________________________
2.
For each of the following statement please circle the response that best
reflects your feeling about that statement.
This program has made an important difference in my life
Strongly Agree
Agree
Disagree
Strongly Disagree
I feel welcome when I attend support group meetings
Strongly Agree
Agree
Disagree
Strongly Disagree
I have learned skills in this program that I use each day
Strongly Agree
Agree
Disagree
Strongly Disagree
I am a better parent as a result of this program
Strongly Agree
Agree
Disagree
Strongly Disagree
I felt safe when raising my point of view in meetings
Strongly Agree
Agree
Disagree
Strongly Disagree
I practice better nutrition as a result of this program
Strongly Agree
Agree
Disagree
Strongly Disagree
I am more aware of community service that can help me as a result of participating in this
program
Strongly Agree
Agree
Disagree
Strongly Disagree
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