We would be deeply grateful if you shared your experience with us. Thank you for helping us evaluate our programs and shape the future of our offerings. Approximately 2 minutes to complete.

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* 1. Program Name and Date

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* 2. Please rate your overall experience of the program

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* 3. I felt safe in the space during the program. 

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* 4. After this program, I am better equipped to respond to stress.

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* 5. When faced with distractions, I am more prepared to maintain focus.

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* 6. I am more resilient and better equipped to bounce back from challenges.

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* 7. How likely is it that you would recommend Copper Beech to a friend or colleague?

NOT AT ALL LIKELY
EXTREMELY LIKELY

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* 8. Additional Comments

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* 9. We invite you to share your name and email to join our community and stay connected.

The following questions are completely optional. All of your individual information will be aggregated anonymously for reporting purposes and to help us understand representation and inclusivity at Copper Beech. We acknowledge that this language is continually evolving, so if there is new/better language for any of these identities that you feel should be included, please contact us at info@copperbeechinstitute.org. 

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* 10. Gender

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* 11. Do you self-identify as BIPOC?

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* 12. Describe your ethnic group or race: [small text box]

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* 13. Sexual Orientation

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* 14. Are you a current or former member of the U.S. Armed Forces, Reserves or National Guard?

T