Exit Survey
Name
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First Name
Last Name
E-mail
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FEV1
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FEF
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Weight
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A1C
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If you need help calculating your BMI, please
click here for the BMI Calculator
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Program Feedback
Please rate everything from 1-(completely disagree) to 10-(completely agree)
I have a better understanding of CFRD as a whole through the education offered from Attain Health:
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The Attain Health program helped to increase my understanding of the impact CFRD has on pulmonary health:
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The Attain Health program helped me to feel more educated about insulin, both timing and dosage:
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I feel more empowered to accurately count carbohydrates and figure out my carb to insulin ratio:
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I feel that Attain Health offered new information that positively impacted how I will care for my diabetes:
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I feel that Attain Health made every effort to support me in my journey:
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I feel more empowered to manage my own care and advocating for myself after going through the CFRD program:
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I feel that my A1C/Blood Sugars are more in control now than it was that I started this program:
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I feel less overwhelmed by CFRD through the education of Attain Health:
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I feel that the CFRD program was worth my time:
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What do you feel was your greatest accomplishment during your work with Attain Health?
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Is there anything that you wish would have been different with the program or your work with Kat?
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Would you recommend this program for others living with CF? If so, why or why not?
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What is your best "take away" from the program?
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During this program, did you experience any prolonged exacerbations or major life stressors you feel may have impacted your progress or mastery of your initial health goals? If "yes," please explain and ideally give dates of hospitalizations so we can pair them with the blood sugar records:
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We know that your words have the potential to drive others in the community to enroll in our program. We would be honored to have a quote from you (1-3 sentences) about your most profound experience or "ah-ha" moment that you that we can share when we start enrolling for our next group. :)
Can we share this quote with your first name and state for grant applications and for promoting the program?
Yes
No
Make Up Webinars
What webinars would you like to make-up or review?
Pathophysiology of disease (Dr. Wood)
Blood Sugar Management, Pharmacist (Dr. Aldridge)
Self Blood Glucose Management (Dr. Wood)
Hypoglycemia (Dr. Wood)
Sick Day Rules (Dr. Wood)
Nutrition and CFRD (Sarah Yourman, RD, CDE)
CFRD and Technology (Teresa Benge, RN, CDE)
Feedback for our Speakers
Dr. Colleen Wood, MD
Dr. John Aldridge, PharmD
Sarah Yourman, RD, CDE
Teresa Benge, RN, CDE
Thank you!
I am so grateful that I got to know you through this program and I appreciate that you chose to share your valuable time with me. Thank you, Kat
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