Living Successfully Post Course Survey

1.Date:

2.City/State of Residence:

3.I consider myself...
Consumer/PatientFamily MemberHealth Care ProfessionalFriend/SupporterOther:

4. I consider myself...
African/AmericanHispanicAsian/Pacific IslanderNative AmericanCaucasian (non-Hispanic)Other

5. My home community is...
UrbanSuburbanRuralOther

6. My age range is...
Under 1819-3031-4041-6565-75Over 75

7. I am most interested in...
Bipolar Disorder InformationDepression InformationInformation about Helping a Love OneOther:

8. My understanding level on the topic of DEPRESSION is currently:
Very HighHighAverageLowUnsure

9. My understanding level on the topic of BIPOLAR DISORDER is currently:
Very HighHighAverageLowUnsure

10. My understanding level on the topic of TREATMENT FOR MOOD DISORDERS is currently:
Very HighHighAverageLowUnsure

11. My understanding level with the topic of PEER SUPPORT FOR MENTAL HEALTH CHALLENGES is currently:
Very HighHighAverageLowUnsure

12. Overall, I had a positive experience during the "Living Successfully" Course:
Strongly AgreeAgreeSomewhat AgreeDisagree

13. The "Living Successfully" Course Facilitator did his/her job well:
Strongly AgreeAgreeSomewhat AgreeDisagree

14. The materials and handouts were helpful:
Strongly AgreeAgreeSomewhat AgreeDisagree

15. I would recommend the "Living Successfully" Course to other people like me.
Strongly AgreeAgreeSomewhat AgreeDisagree

16. The most important thing that I learned during the "Living Successfully" course is:

17. Any other comments?

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