Aseshate:ka'te Grief Recovery Group Evaluation
This evaluation will help Aseshate:ka'te Grief Services further develop what it has to offer Onkwehonweh people dealing with grief issues. Please feel free to be as open and honest about your experience dealing with your grief issues utilizing this process to heal. Niawen.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Would you be interested in attending maintenance groups in the future to continue working on your grief? (Due to pandemic, in person is not currently offered and zoom offerings are in development)
Yes
No
Undecided at this time
How satisfied were you with the process in addressing your grief issues? 1 being not so much, 5 being very satisfied in addressing my grief issues.
1
2
3
4
5
Healing Outcomes
Could you explain any impacts this process had in addressing your grief issues in the following areas:
Emotional health: (Do you feel differently or have you noticed any changes about your emotions about grief in your life? Please explain.)
Mental health: (Do you think differently or have you learned anything new about grief in your life? Please explain.)
Physical health: (Did you notice or experience any changes about your physical health/body since the process of working on your grief issues? Please explain.)
Spiritual health: (Did you experience any spiritual connections or changes about yourself spiritually, since the process of working on your grief issues? Please explain.)
Other areas (relationships/work/school) or would you like to share any take-aways from completing this process of healing grief?
Do you have any suggestions on how the group could improve?
What did you like about the group?
What didn't you like about the group?
Do you have any suggestions for the facilitator to improve upon delivery of the material?
Would you recommend this group to someone else?
Yes
No
Would you be willing to write a testimonial expressing the value of attending the grief sessions had on addressing your grief issues? If so, please share below. *Your testimonial may be printed on brochures or on the website as encouragement for others who may need help working through their grief. Because this group is confidential, your name at the end of the testimonial is optional. Feel free to use "anonymous" or just your initials to maintain your anonymity if you choose. Niawen!
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