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Thank you so much for your participation in National Healthcare Decisions Day. Please complete the following few questions so that we may know how successful the event was this year and how we can improve it further. To assist with analysis, please use numeric responses as opposed to word responses (ex. 100 vs. one hundred).

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* 1. Please describe your organization (hospital, nursing home, organization, coalition, law firm, etc.).

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* 2. How many years have you participated in NHDD?

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* 3. Did you provide advance directive education to your staff?

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* 4. Did you provide advance directive education to the public?

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* 5. How many people executed an advance directive during your NHDD event (if you know) (please provide numeric answer)?

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* 6. Did you provide information about NHDD to your members/affiliates/others, through any print or electronic means?

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* 7. Did you see NHDD mentioned/covered in any of the following? (Note: you may mark multiple entries)

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* 8. Did you follow NHDD in the social media? (If yes, mark all those that apply)

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* 9. What was the most satisfying/effective part of NHDD?

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* 10. How can NHDD be improved?

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* 11. Please provide any additional comments about your NHDD experience.

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* 12. OPTIONAL: Please provide your Organization/Facility name.

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* 13. OPTIONAL: Please provide your email address.

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