TLC Closing Survey

We want to know how you feel about your experience in the Ele's Place TLC program. Please choose your answers to the following questions. NOT AT ALL means you do not agree. VERY MUCH means you agree the most.

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1. .

	Not at all	Not so much	Sometimes	Mostly	Very Much
I liked my TLC group.	I liked my TLC group. Not at all	I liked my TLC group. Not so much	I liked my TLC group. Sometimes	I liked my TLC group. Mostly	I liked my TLC group. Very Much
Adults in my group were nice to me.	Adults in my group were nice to me. Not at all	Adults in my group were nice to me. Not so much	Adults in my group were nice to me. Sometimes	Adults in my group were nice to me. Mostly	Adults in my group were nice to me. Very Much
I could talk about my feelings in my group, if I wanted to.	I could talk about my feelings in my group, if I wanted to. Not at all	I could talk about my feelings in my group, if I wanted to. Not so much	I could talk about my feelings in my group, if I wanted to. Sometimes	I could talk about my feelings in my group, if I wanted to. Mostly	I could talk about my feelings in my group, if I wanted to. Very Much
Adults in my group listened to me when I talked.	Adults in my group listened to me when I talked. Not at all	Adults in my group listened to me when I talked. Not so much	Adults in my group listened to me when I talked. Sometimes	Adults in my group listened to me when I talked. Mostly	Adults in my group listened to me when I talked. Very Much
I feel less alone since going to TLC.	I feel less alone since going to TLC. Not at all	I feel less alone since going to TLC. Not so much	I feel less alone since going to TLC. Sometimes	I feel less alone since going to TLC. Mostly	I feel less alone since going to TLC. Very Much
Since going to TLC, it is easier for me to talk about the illness with my family.	Since going to TLC, it is easier for me to talk about the illness with my family. Not at all	Since going to TLC, it is easier for me to talk about the illness with my family. Not so much	Since going to TLC, it is easier for me to talk about the illness with my family. Sometimes	Since going to TLC, it is easier for me to talk about the illness with my family. Mostly	Since going to TLC, it is easier for me to talk about the illness with my family. Very Much
I can deal with my feelings better since going to TLC.	I can deal with my feelings better since going to TLC. Not at all	I can deal with my feelings better since going to TLC. Not so much	I can deal with my feelings better since going to TLC. Sometimes	I can deal with my feelings better since going to TLC. Mostly	I can deal with my feelings better since going to TLC. Very Much
Going to TLC helped my family.	Going to TLC helped my family. Not at all	Going to TLC helped my family. Not so much	Going to TLC helped my family. Sometimes	Going to TLC helped my family. Mostly	Going to TLC helped my family. Very Much

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2. Your Group:

Middle School

High School

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3. How long did you come to Ele's Place?

1 month or less

2-4 months

5-8 months

9 months - 1 year

More than a year

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4. What was most helpful to you in Ele's Place TLC program?

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5. Is there anything in the TLC program that was NOT helpful to you? If yes, please explain.

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6. What would you change about how we do things at Ele's Place?

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7. Optional:

Name:

Email Address:

Phone Number:

TLC Closing Survey - Child

1. Satisfaction Survey

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1. .

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2. Your Group:

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3. How long did you come to Ele's Place?

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4. What was most helpful to you in Ele's Place TLC program?

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5. Is there anything in the TLC program that was NOT helpful to you? If yes, please explain.

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6. What would you change about how we do things at Ele's Place?

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7. Optional: