VCHA Food as Medicine Facilitator Reporting Survey

Your feedback is essential in helping us understand the impact of our curriculum on participants' health and well-being. This survey will help us identify effective strategies and areas for improvement to enhance our initiatives. Your responses will guide us in refining our efforts.

For immediate questions and/or concerns, please contact info@vcha.org.

Question Title

* 1. Session(s) Taught?

Session 1: Healthful Foods and Balanced Meals

Session 2: Portion Control and Active Living

Session 3: Heart Health, Fat, and Cholesterol

Session 4: Understanding Barriers and Goal Setting

Session 5: Carbohydrates

Session 6: Fiber, Water, and Sugar Substitutes

Session 7: Protein and Sodium

Session 8: Budget Friendly Foods and Budgeting Tips

Session 9: Strategies for Healthy Eating and Meal Planning

Session 10: Food Safety and Food Waste

Session 11: Cooking Demonstration

Session 12: Program Summary, Resource Review, and Next Steps for Lifelong Success

Question Title

* 2. Number of participants in your session(s)?

Question Title

* 3. Session Date(s)?

Question Title

* 4. Health Center/Organization Name

Question Title

* 5. Session location/format? (Check all that apply)

In person

Virtual

Hybrid

Question Title

* 6. During your session, if you collected specific data metrics on participants (A1c, blood pressure etc.), please note the TOTAL number of participants with an A1C >9 and/or blood pressure >140/90.

# of participants with A1C > 9

# of participants with blood pressure >140/90

I collected other metric data (please add)

I did not collect participant health data during my session

VCHA Food as Medicine Facilitator Reporting Survey

Question Title

* 1. Session(s) Taught?

Question Title

* 2. Number of participants in your session(s)?

Question Title

* 3. Session Date(s)?

Question Title

* 4. Health Center/Organization Name

Question Title

* 5. Session location/format? (Check all that apply)

Question Title

* 6. During your session, if you collected specific data metrics on participants (A1c, blood pressure etc.), please note the TOTAL number of participants with an A1C >9 and/or blood pressure >140/90.

Question Title

* 7. What parts of the session(s) were the most valuable and/or engaging?

Question Title

* 8. What parts of the session(s) could be improved?

Question Title

* 9. Please provide any additional feedback about the session(s).