WA Eval Survey

Wellness Advocate Evaluation of Services

Thank you for your willingness to provide feedback regarding your recent WA experience.

THE INFORMATION THAT YOU PROVIDE IS STRICTLY CONFIDENTIAL.

1. Date you met with a Wellness Advocate.

Date you met with a Wellness Advocate.

2. Please tell us how you perceived the Wellness Advocate

	Excellent	Good	Fair	Poor	N/A
Helpful	*Please tell us how you perceived the Wellness Advocate Helpful Excellent	Helpful Good	Helpful Fair	Helpful Poor	Helpful N/A
Understanding of your feelings	Understanding of your feelings Excellent	Understanding of your feelings Good	Understanding of your feelings Fair	Understanding of your feelings Poor	Understanding of your feelings N/A
Listened to what I had to say	Listened to what I had to say Excellent	Listened to what I had to say Good	Listened to what I had to say Fair	Listened to what I had to say Poor	Listened to what I had to say N/A
Acceptance of you as a person	Acceptance of you as a person Excellent	Acceptance of you as a person Good	Acceptance of you as a person Fair	Acceptance of you as a person Poor	Acceptance of you as a person N/A
Genuineness	Genuineness Excellent	Genuineness Good	Genuineness Fair	Genuineness Poor	Genuineness N/A
Overall s/he is	Overall s/he is Excellent	Overall s/he is Good	Overall s/he is Fair	Overall s/he is Poor	Overall s/he is N/A
S/he helped me stay in school	S/he helped me stay in school Excellent	S/he helped me stay in school Good	S/he helped me stay in school Fair	S/he helped me stay in school Poor	S/he helped me stay in school N/A
S/he has helped my academic performance	S/he has helped my academic performance Excellent	S/he has helped my academic performance Good	S/he has helped my academic performance Fair	S/he has helped my academic performance Poor	S/he has helped my academic performance N/A

3. Which Wellness Advocate did you speak to?

Which Wellness Advocate did you speak to? Alissa Collier

Amanda Whelan

Amber Perkins

Amy Smith

Ashley Holzer

Asia Mills-Burton

Beth Anne Sanford

Beverly Holtz

Carrin Dresser

Diana Gugino

Erin Casey

Juliana Brush

Julie Hollis

Kaitlin Flack

Karleen Hayes

Kate Haggerty

Kati Tan

Leo Adle

Marlena Lovaglio

Mikayla Robert

Sara Pinsker

Shanequa Nurse

Tanasia Betts

Varvara Yakuta

I don't know his/her name

6. What things did the Advocate do that you felt to be MOST and LEAST helpful?

What things did the Advocate do that you felt to be MOST and LEAST helpful?

7. In relation to your experience with the Wellness Advocates, please rate the following items:

	Excellent	Good	Fair	Poor
Ease of finding contact number	*In relation to your experience with the Wellness Advocates, please rate the following items: Ease of finding contact number Excellent	Ease of finding contact number Good	Ease of finding contact number Fair	Ease of finding contact number Poor
Welcoming Initial contact	Welcoming Initial contact Excellent	Welcoming Initial contact Good	Welcoming Initial contact Fair	Welcoming Initial contact Poor
Waiting time to reach a WA	Waiting time to reach a WA Excellent	Waiting time to reach a WA Good	Waiting time to reach a WA Fair	Waiting time to reach a WA Poor

8. Think back to the concern for which you originally called a Wellness Advocate.
Please describe how you are NOW dealing with this problem and any changes that you have made.

Think back to the concern for which you originally called a Wellness Advocate. Please describe how you are NOW dealing with this problem and any changes that you have made.

9. Other comments or suggestions about the general functioning of the Wellness Advocates and how we might improve our services.

Other comments or suggestions about the general functioning of the Wellness Advocates and how we might improve our services.

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