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AMI-Quebec Support Group Evaluation 2021-2022
We ask you these questions to serve you better. All information is kept confidential.
1.
Which Support Group did you attend today?
Anxiety / OCD
Bipolar
BPD For Families
Depression
Family & Friends
Young Family & Friends
Hoarding
Kaleidoscope
South Shore (Wednesday Nights)
Other (please specify)
2.
Are you new to our support groups?
First Time
Relatively New
Intermediate
Long Time Attendee
Other (please specify)
3.
How did you hear about AMI-Quebec?
Web Search
Family / Friends
Community Organization
Healthcare Professional (Doctor, CLSC, Social Worker etc.)
Social Media (Facebook, Twitter etc.)
811
Other (please specify)
4.
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
Prefer Not To Say
5.
How would you describe your gender?
Female (including transgender women)
Male (including transgender men)
Non-binary, Gender-fluid, Agender
Prefer Not To Answer
6.
What do you identify as? (check all that apply)
Indigenous (Aboriginal, First Nations, Inuit, Metis, Multiple Indigenous Identities)
Arab (Syrian, Lebanese, Palestinian)
Black (Caribbean, African, Latin American, Black Canadian etc.)
East Asian (Chinese, Japanese, Korean etc.)
Latin American (Peruvian, Brazilian, Argentinian etc.)
Middle Eastern
South Asian (Bangladeshi, Indian, Pakistani, Sri Lankan etc.)
West Asian (Iranian, Afghan etc.)
White (European descent)
Prefer not to answer
Other (please specify)
7.
What is your role?
I have a loved one with mental health challenges
I have mental health challenges
Both of the above
I am a Social Worker / Doctor
Other (please specify)
8.
Where do you live?
Montreal
Off Island Suburbs (Laval, South Shore etc.)
Rest of Quebec
Other (please specify)
9.
Why did you seek help from us today?
10.
Was this support group helpful to you? (Yes, No, Maybe). Please explain:
11.
Did you have enough opportunity to participate? (Yes, No, Maybe). Please explain:
12.
Were you satisfied with the Facilitators? (Yes, No, Maybe). Please explain:
13.
Do you have other comments or suggestions?
14.
Do you have any suggestions for new events at AMI-Quebec?
15.
Would you like monthly emails about AMI-Quebec's programs, news, and upcoming events? If yes, put your email address below:
16.
Want to speak to someone from AMI-Quebec? Please provide your name and contact info:
17.
Want to give back to AMI-Quebec?
To Donate, click here:
https://amiquebec.org/donate/
To Become A Member, click here:
https://amiquebec.org/membership/
To Volunteer, click here:
https://amiquebec.org/volunteer/
To Promote, write AMI-Quebec a Google Review online!
Other (please specify)
