NAMI Recovery Support Survey
Thank you for taking a few minutes to take this survey. Your participation is crucial in order for us to receive our funding!
Overall Evaluation
Select any programs you have participated in during the last three months:
*
Direct Service (1:1 recovery support, advocacy, and/or family support)
Support Workshop/Event
Connections Support Group
Family Support Group
On a scale of 1-5, how well did the program/service meet your expectations? (1 = Below Expectations and 5 = Above Expectations)
*
Below Expectations
1
2
3
4
Above Expectations
5
1 is Below Expectations, 5 is Above Expectations
On a scale of 1-5, how satisfied are you with this program/service? (1 = Extremely Unsatisfied and 5 = Extremely Satisfied)
*
Extremely Unsatisfied
1
2
3
4
Extremely Satisfied
5
1 is Extremely Unsatisfied, 5 is Extremely Satisfied
On a scale of 1-5, how valuable is this program/service in your life? (1 = Not Valuable at All and 5 = Extremely Valuable)
*
Not Valuable
1
2
3
4
Extremely Valuable
5
1 is Not Valuable, 5 is Extremely Valuable
Increased Knowledge & Functioning
I learned something new from this experience that I didn’t know before
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
I am better prepared to meet my needs or the needs of my family member after this experience
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Feeling nervous anxious, or on edge
*
Please Select
Not at all
Several days
More than half the days
Nearly every day
Not being able to stop worrying or controlling your thoughts
*
Please Select
Not at all
Several days
More than half the days
Nearly every day
Lack of interest in doing things
*
Please Select
Not at all
Several days
More than half the days
Nearly every day
Feeling sad or depressed
*
Please Select
Not at all
Several days
More than half the days
Nearly every day
Thinking about ending your life
*
Please Select
Not at all
Several days
More than half the days
Nearly every day
Other Feedback
Please list any other comments here about what you liked, or how we can improve this program/service (optional):
Type first initial, last name, and DOB to sign the document
*
Example: John Smith with birthday 01/01/1992 would type "jsmith01011992"
Submit
Should be Empty: