Rural Mental Wellness Toolkit 

Feedback Form 

1.What is your gender?
2.Where do you live?
3.What is your overall rating of the website? Rate from 1 to 10 (10 being excellent)
4.What, in your opinion, were the two most effective sections on the site?
Pick first most effective section below.
5.Pick second most effective section below.
6.Please tell us why you felt these sections were effective. 
7.What section on this site needs the most improvement?
8.Please tell us why you felt this section needs improvement. 
9.Can we contact you for more information to gather more feedback?
10.Do you want to sign up for the Stigma-Free Mental Health's newsletter?
11.Email Address
12.Do you have any more comments or questions?
13.By submitting this form, you give Stigma-Free Mental Health Society consent to the collection, use, and retention of your personal information as authorized under the Personal Information Protection Act and/or the Freedom of Information and Protection of Privacy Act. Your information will be used only for the purpose outlined in our - Cookie & Privacy Policy.