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* 1. To what extent do you agree with this statement: "The time spent today with the volunteers has been beneficial." 你同意这个说法吗？“我今天跟志愿者度过了一段美好的时光。“

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* 2. In what ways have you benefited from the volunteering?  你从哪些方面受益？

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* 3. On a scale of 1 – 10 (1: unlikely, while 10 is very likely), how likely are you to tell other caregivers about today's experience? 你会跟其他看护者
分享今天的经验吗？ 请用1到10的等级来评估这个说法。
1：不太可能，  10：很有可能）

1 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 4. If you had more time to yourself, what would be ONE other activity you hope to do?  如果你有更多的时间，你希望做那些活动？

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* 5. What would be ONE other volunteer role that you would be keen to receive help from? / 您还有哪些方面需要志愿者的帮忙或协助？

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* 6. What is the date of today's interaction? / 请写下日期和时间

Date

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* 7. Which organization did you receive this volunteering service from? / 哪个社会组织与您联系？

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* 8. Would you like to leave a message for the volunteers or the organizer (encouragement or areas to be done differently)?你要给组办单局留言吗？

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* 9. What do you hope or wish for in order to improve the quality of life for your loved ones? / 为了改善亲人的生活质量，您希望或希望如何？

T