#BeMyVoiceLongBeach Feedback Survey Thank you for attending the #BeMyVoiceLongBeach Events! Please take a moment to complete this feedback survey. We value your input. OK Question Title * 1. What event did you attend? April 23: Workshop - Financial Aspects of Caregiving and Perspectives on Palliative Care April 24: “Death Over Dessert” in Women & Aging: Lessons from the Golden Girls April 25: “BeMyVoiceLongBeach: Palliative Care and You” - Center for Successful Aging Colloquium April 27: StoryCorps “Hear Me Now” Lunch and Learn April 28: "Listening is an Act of Love" OK Question Title * 2. What role best describes you? (select one) CSU Long Beach Student CSU Long Beach Staff/Faculty Community Member Long Beach Memorial Employee Other (please specify) OK Question Title * 3. What is your age range? (select one) Under 18 18-24 25-34 35-44 45-54 55-64 65 and Over OK Question Title * 4. Rate your knowledge of advance care planning prior to attending the event. No knowledge Somewhat familiar with the subject Very familiar with the subject OK Question Title * 5. Rate your knowledge of palliative care prior to attending the event. No knowledge Somewhat familiar with the subject Very familiar with the subject OK Question Title * 6. Do you have an advance directive? Yes No OK Question Title * 7. Have you identified someone who can speak for you if you were unable to speak for yourself? Yes No OK Question Title * 8. How likely are you to engage in advance care planning after this event? Highly unlikely Unlikely Neutral Likely Very likely OK Question Title * 9. What type of action will you take? (select all that apply) Talk to my loved ones about my wishes. Complete an advance directive. Talk to my loved ones about their wishes. Encourage them to complete an advance directive. Other (please specify) OK Question Title * 10. Rate your knowledge of advance care planning after attending the event. No knowledge Somewhat familiar with the subject Very familiar with the subject OK Question Title * 11. Rate your knowledge of palliative care after attending the event. No knowledge Somewhat familiar with the subject Very familiar with the subject OK Question Title * 12. 12. What would you like to see more of from future events surrounding advance care planning? OK Thank you for taking the time to complete this survey. For additional information, please visit our website: talkaboutwhatmatters.org OK DONE