Programme – (Health) – County Down Rural Community Network

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About CDRCN
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Training & Events

Programme Evaluation Feedback – Health Team

Step 1 of 3

33%

Name of Programme(Required)

Programme Venue(Required)

Date(Required)

Day

Month

Year

On a scale from 1 to 5 (with 1 being low/very poor/no relevance and 5 high/very good/very relevant), please rate the following

Please rate the overall programme

1

2

3

4

5

How useful/relevant was this programme to your needs?

1

2

3

4

5

I received helpful information about local support services

1

2

3

4

5

I found out about other activities/programmes/events happening in my community

1

2

3

4

5

I gained new skills/knowledge

1

2

3

4

5

I enjoyed taking part and spending time with others

1

2

3

4

5

It was beneficial to my mood

1

2

3

4

5

I felt connected to people/ families in my community

1

2

3

4

5

It reduced loneliness/ isolation

1

2

3

4

5

It has made me more interested in joining future community events

1

2

3

4

5

Would you recommend this programme to others?

Yes

No

Please make any other comments regarding the programme

Consent

May we use your feedback anonymously in reports or case studies?

Yes

No

If yes, please provide contact details (optional):

Would you be happy to be contacted for a follow-up or case study interview?

Yes

No

Equality & Section 75 Monitoring Return Form
All information will be strictly treated and kept as Private & Highly Confidential. Please tick all relevant boxes that apply. Many thanks for your help in gathering this information.

Gender

Female

Male

Transgender

Age

Under 25

25-40

40-60

60-75

Over 75

Ethnicity / Racial Group

White

Chinese

Indian

Pakistani

Bangladeshi

Black African

Black Caribbean

Irish Traveller

Other

Community Background

Protestant Community / Background

Roman Catholic Community / Background

I do not have a Protestant or Roman Catholic Background

Other

Disability / Illness

I have a Disability

I do not have a Disability

Carers / Dependants Do you have caring responsibilities ?

No caring responsibilities

My Child(ren)

Other

Sexual Orientation

Heterosexual / Straight

Homosexual / Gay / Lesbian

Bisexual

Other

Thank you for taking time to complete this evaluation, your comments can help us continuously improve our training and events.

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Downpatrick
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