1.Today's conference provided new perspectives and/or resources that I can use to help myself or others when faced with end of life and/or grief.

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

2.Today's conference will help me talk about end-of-life issues and grief more comfortably.

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

3.How effective were today's speakers in presenting on supporting loss, caregiving fatigue, and end-of-life conversations?

Very effective

Somewhat effective

Neutral

Somewhat ineffective

Very ineffective

4.I am satisfied with the length of today's conference.

Agree

Would have preferred it to be shorter

Would have preferred it to be longer

5.Overall, how satisfied were you with today's Thresholds Conference?

Very satisfied

Somewhat satisfied

Not satisfied

6.How likely are you to refer someone to Andwell Health Partners?

Very likely

Somewhat likely

Not likely

N/A

7.What was your biggest take-away from today's conference?

8.What was your favorite part of today's conference?

9.What other hospice-related topics should we consider for future programs?

10.Please add any additional conference comments/feedback here.

11.I would like Andwell Health Partners to contact me about...(check all that apply)

Grief support services.

Referring someone to hospice.

Becoming a volunteer.

Other

12.Please fill in contact information as it pertains to Question #11.

Name

Email Address

Phone Number