CAPS Outreach Evaluation Form Survey

Question Title

* 2. Please select the outreach event that you are evaluating:

Wellness Workshop Series: CAPS Collaboration with EOP (e.g., Cafe Connect, Managing Anxiety, Relationships, Grief)

Wellness Workshop Series for Black and Indigenous Students, and all Persons/Students of Color (BIPOC)

Self-Compassion, Fatigue, and Grief

Wellness and Community Space for Muslim Students

Community Check-in: Supporting One Another in the time of Pandemic, Xenophobia, and Remote Learning

Tools to Navigate the Current Collective Experiences

Wellness in Action Workshop Series

Mindfulness Workshop

Other

Question Title

* 3. If you marked "other," what is the name of the outreach program that you attended?

Question Title

* 4. Please indicate the name(s) of the facilitator:

Alie, Laura

Amin, Sonia

Anderson, Adisa

Aranda, Elizabeth

Arroyo, Paola

Baillie, Jeanine

Bell, Sue

Bi, Yu

Bines, Derrick

Blum, Sasha

Capone, Don

Chan, Kin-Ming

Chaney, Elizabeth

Chang, Christine

Chiovarelli, Rich

Cohen, Aaron

Davis III, Claytie

Du, Yi

Godinez, Andrea

Goodman, Matt

Guthrie, Carrie

He, Xiao

Honigman, Amy

Huynh, Kiet Duc

Jackson, Genee

Jones, Jai

Khan, Nabilah

Kim, Helen

Kusin, Elizabeth

Landsbaum, Holly

Lee, Paige

Lee Tsugawa, Karen

Lin, Tiffany

Meza, Daniel

McLean, Chris

Medina, Cynthia

Midili, Gina

Murarka, Kusha

Orozco, Veronica

Pena, Diana

Quach, Lisa

Straussman, Jason

Tourek, Sam

Zaruba, Linda

Zhou, Christine

Question Title

* 5. Are you an:

Undergraduate Student

Graduate Student

Parent of a Cal Student

Cal Faculty/Staff

Other

Question Title

* 6. Are you in the 1st generation in your family to attend college?

Yes

Question Title

* 7. Do you identify as low-Income, or have a Pell Grant or Dream Grant in your financial aid?

Yes

Question Title

* 8. Are you an international student?

Yes

Question Title

* 9. Gender:

Female

Male

Transgender

Genderqueer/Gender Fluid/Gender NonConforming

Question Title

* 10. Ethnicity (Check all that apply):

African American/Black

American Indian/Alaska Native

Chinese/Chinese-American

East Indian/Pakistani

Filipino/Filipino-American

Japanese/Japanese-American

Korean/Korean-American

Polynesian/Micronesian

Vietnamese/Vietnamese-American

Other Asian

Mexican/Mexican-American/Chicano

Middle-Eastern

Puerto Rican

Other Spanish/American/Latino

White/Caucasian

Decline to Answer

Other (please specify)

Question Title

* 11. How effective was this program in:

	Very Effective	Mostly Effective	Somewhat Effective	Mostly Ineffective	Very Ineffective	N/A
Providing information that was relevant to you?	Providing information that was relevant to you? Very Effective	Providing information that was relevant to you? Mostly Effective	Providing information that was relevant to you? Somewhat Effective	Providing information that was relevant to you? Mostly Ineffective	Providing information that was relevant to you? Very Ineffective	Providing information that was relevant to you? N/A
Offering new skills that you can use in your daily life?	Offering new skills that you can use in your daily life? Very Effective	Offering new skills that you can use in your daily life? Mostly Effective	Offering new skills that you can use in your daily life? Somewhat Effective	Offering new skills that you can use in your daily life? Mostly Ineffective	Offering new skills that you can use in your daily life? Very Ineffective	Offering new skills that you can use in your daily life? N/A
Increasing your understanding of mental health issues	Increasing your understanding of mental health issues Very Effective	Increasing your understanding of mental health issues Mostly Effective	Increasing your understanding of mental health issues Somewhat Effective	Increasing your understanding of mental health issues Mostly Ineffective	Increasing your understanding of mental health issues Very Ineffective	Increasing your understanding of mental health issues N/A
Increasing your awareness of UC Berkeley Counseling and Psychological Services	Increasing your awareness of UC Berkeley Counseling and Psychological Services Very Effective	Increasing your awareness of UC Berkeley Counseling and Psychological Services Mostly Effective	Increasing your awareness of UC Berkeley Counseling and Psychological Services Somewhat Effective	Increasing your awareness of UC Berkeley Counseling and Psychological Services Mostly Ineffective	Increasing your awareness of UC Berkeley Counseling and Psychological Services Very Ineffective	Increasing your awareness of UC Berkeley Counseling and Psychological Services N/A
Demonstrating sensitivity to multicultural differences?	Demonstrating sensitivity to multicultural differences? Very Effective	Demonstrating sensitivity to multicultural differences? Mostly Effective	Demonstrating sensitivity to multicultural differences? Somewhat Effective	Demonstrating sensitivity to multicultural differences? Mostly Ineffective	Demonstrating sensitivity to multicultural differences? Very Ineffective	Demonstrating sensitivity to multicultural differences? N/A
Increasing your comfort in seeking counseling for yourself during times of need?	Increasing your comfort in seeking counseling for yourself during times of need? Very Effective	Increasing your comfort in seeking counseling for yourself during times of need? Mostly Effective	Increasing your comfort in seeking counseling for yourself during times of need? Somewhat Effective	Increasing your comfort in seeking counseling for yourself during times of need? Mostly Ineffective	Increasing your comfort in seeking counseling for yourself during times of need? Very Ineffective	Increasing your comfort in seeking counseling for yourself during times of need? N/A
Increasing your comfort in referring others (students) to counseling during their times of need?	Increasing your comfort in referring others (students) to counseling during their times of need? Very Effective	Increasing your comfort in referring others (students) to counseling during their times of need? Mostly Effective	Increasing your comfort in referring others (students) to counseling during their times of need? Somewhat Effective	Increasing your comfort in referring others (students) to counseling during their times of need? Mostly Ineffective	Increasing your comfort in referring others (students) to counseling during their times of need? Very Ineffective	Increasing your comfort in referring others (students) to counseling during their times of need? N/A

Question Title

* 12. Please rate your overall satisfaction with:

	Extremely Satisfied	Satisfied	Somewhat Satisfied	Somewhat Dissatisfied	Dissatisfied	Extremely Dissatisfied
The Program:	The Program: Extremely Satisfied	The Program: Satisfied	The Program: Somewhat Satisfied	The Program: Somewhat Dissatisfied	The Program: Dissatisfied	The Program: Extremely Dissatisfied
The Presenter:	The Presenter: Extremely Satisfied	The Presenter: Satisfied	The Presenter: Somewhat Satisfied	The Presenter: Somewhat Dissatisfied	The Presenter: Dissatisfied	The Presenter: Extremely Dissatisfied

CAPS Outreach Evaluation Form

Wellness Workshops during COVID-19

Question Title

* 1. What's the date of the program that you attended? (Please enter as mm/dd/yyyy)

Question Title

* 2. Please select the outreach event that you are evaluating:

Question Title

* 3. If you marked "other," what is the name of the outreach program that you attended?

Question Title

* 4. Please indicate the name(s) of the facilitator:

Question Title

* 5. Are you an:

Question Title

* 6. Are you in the 1st generation in your family to attend college?

Question Title

* 7. Do you identify as low-Income, or have a Pell Grant or Dream Grant in your financial aid?

Question Title

* 8. Are you an international student?

Question Title

* 9. Gender:

Question Title

* 10. Ethnicity (Check all that apply):

Question Title

* 11. How effective was this program in:

Question Title

* 12. Please rate your overall satisfaction with:

Question Title

* 13. In what ways is this virtual format meeting your mental health needs during COVID-19?

Question Title

* 14. Any suggestions for improving this program, including topics/resources that will assist you in coping during the COVID-19 pandemic?