Participants' name
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First Name
Last Name
What programme did you engage in?
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Do you see yourself as confident and do you believe in yourself and abilities?
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Please elaborate
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Do you think that you are resilient and determined to overcome challenges?
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Please elaborate
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Please provide any additional helpful information you would like to give?
I've been feeling optimistic about the future
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling useful
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling relaxed
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling interested in other people
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've had energy to spare
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been deeling with problems well
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been thinking clearly
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling good about myself
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling close to other people
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling confident
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been able to make up my own mind about things
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling loved
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been interested in new things
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
I've been feeling cheerful
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Please enter a number between 1 and 5 with 1 being none of the time, 2, rarely, 3 some of the time, 4 often and 5 all the time
Please tell us what you think of the programme(s) you are involved in
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If you didn't enjoy any programme you engaged in, we would really appreciate your feedback why. Thanks
Would you recommend this programme to others?
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If yes, why?
If no, we would really appreciate your feedback why. Thanks
What benefits, if any, have you received from participating in this programme?
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Please select all that apply.
It has helped me to manage my mental health
It has helped me to manage my physical health
It has helped me to build new friendships
It has helped me to feel more connected to my local community
I have been able to try new activities
It has helped me to do more activities than I would have done without the project
I have enjoyed participating in activities as part of this project
The project has given me more confidence to be active
I have not received any benefits from participating in this project
Don’t know
Other benefits I got from this programme
How would you rate your overall experience of participating in this programme? Please consider all aspects of the programme in your answer, e.g. the activities, the support you received, the environment etc. Please answer on a scale of 1-10 where 1 extremely poor and 10 is excellent.
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Please let us know the reason for giving your score
How, if at all, do you think the programme can be improved?
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We would really appreciate a testimonial from you on the benefits of this programme as your declaration can help secure more funding to support more of our community!
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