Please enable JavaScript in your browser to complete this form.Name (Optional)FirstLastDate / Time *Name of Support Group *ZIP Code *How strongly would you agree with the statements about your faciltator(s)0 = Strongly Disagree; 7 = Strongly AgreeThe facilitator made me feel welcome while attending the support group meetings Selected Value: 0 0 = Strongly Disagree; 7 = Strongly AgreeThe facilitator encouraged discussion from all group members Selected Value: 0 0 = Strongly Disagree; 7 = Strongly AgreeThe facilitator was flexible in adjusting to the groups needs Selected Value: 0 0 = Strongly Disagree; 7 = Strongly AgreeProgram FeedbackHow would you rate your improvement in coping with your grief after your experiences in this group? Selected Value: 0 0 = Low Improvement; 7 = High ImprovementHow would you rate your feelings of gaining support from other group members and the facilitator/discussion Selected Value: 0 0 =Low Support ; 7 = High SupportI would recommend this FVHH group to others needing grief support Selected Value: 0 0 = Strongly Disagree; 7 = Strongly AgreeHow did you hear about this group?What did you find most helpful about this group?What did you find least helpful about this group?How can we improve this group for the future, and are there any specific topics you would like to see presented on?MessageSubmit