1. Questions about your Pulse Check Event during Arrhythmia Awareness Week (AAAW), 7th – 13th June 2010

For those of you that held a Pulse Check session or Cardiac Café during this year’s Arrhythmia Awareness Week please fill out this questionnaire about your event.

The information you provide will be used to highlight the local and regional impact of the ‘Know Your Pulse’ campaign during AAAW.

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* 1. On what date did your event take place?

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* 2. Where was the session located?

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* 3. What was the event's duration?

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* 4. Please could you provide some information about the event organisers

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* 5. How many trained professionals were involved?

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* 6. How many people did you see in total across your pulse check event?

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* 7. Please select the age groups that were involved in the Pulse Check Event

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* 8. How many follow-ups or referrals did you make? If known, where did these take place?

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* 9. On average, how long did the pulse checks take?

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* 10. Do you feel that your event was successful in raising awareness of pulse checking?

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* 11. How would you rate the success of your event as a percentage?

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* 12. Which of the following resources from your Pulse Check Pack did you use/hand out at your event?

  Pulse Check Cards/Pulse Check Sheets Blackouts Checklist Palpitations Checklist Arrhythmia Checklist Posters Stickers
Yes
No

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* 13. Were the materials supplied suitable for your event? If not, please give us feedback on how we can improve our resources to meet your needs. Perhaps you could give details of any extra resources you might have also wanted or needed for your event.

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* 14. Would you hold a similar event again?

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* 15. Would you be happy for us to promote the success of your event in our publications?

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