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Program Feedback
Patient Evaluation of Program
Please Write Your Full Name
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First Name
Last Name
Yes or No: Online education has been useful.
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Yes
No
Do you feel the program helped you manage your chronic condition?
Not Helpful
1
2
3
4
5
6
7
8
9
Extremely Helpful
10
1 is Not Helpful, 10 is Extremely Helpful
Did the program meet your expectations? Why or Why Not?
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What part of the program did you find most helpful?
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Were there any parts of the program that were unhelpful or unnecessary? If so what were they?
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Did you feel that the program provided enough support? If not what additional support would you have liked to receive?
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Did you encounter any difficulties or challenges while participating in the program? If yes, what were they?
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On a scale of 1-10, How satisfied are you with the communication and responsiveness of program staff?
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
Would you recommend this program to others? Why or why not?
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Do you have any suggestions for how the program could be improved to better meet the needs of participants?
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How can we make the program better? We would love to hear from you!
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Is there anything else you would like to share about your experience?
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Please write any comments about what you have enjoyed about the program below!
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Were you able to go to Thrive Let us know if you've gone and what your experience was like!
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Were you able to use the Food as Medicine Program and get fresh fruits and vegetables?
Yes
No
If Yes, how many times have you used the service? We would love to hear about your experience!
We would love to hear about your experience with Food as Medicine Program!
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Thank you for taking the time to complete this survey! Your feedback is valuable to us as we work to improve our program.
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