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English (US)
Reproductive Grief Care Program Exit Evaluation
Name (optional)
First Name
Last Name
Your Advocate
Please Select
Carol
Curtis
Olivia
Raquel
Tanya
Toni
Please indicate your level of satisfaction with the program:
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Your Advocate
The Curriculum
Length of Program
Length of Sessions
Type of Meetings (please select all that apply)
In-person
Online
Group
Individual
Were you satisfied with the type of meetings?
yes
no
What was the hardest part of the program for you?
What was the easiest part of the program for you?
Did you ever feel unsafe in the program?
yes
no
If yes, please explain why:
Has you relationship with God improved or been hindered? Please explain:
Do you feel freer to talk about your reproductive loss experience now or less inclined to mention it?
If you feel an area of your life has improved, please share how:
Do you feel your experience with Reproductive Grief Care has left you satisfied with enough tools and support or left you in need and longing for more help?
Would you recommend SPH's Reproductive Grief Care Program?
yes
no
unsure
Please share any additional suggestions or concerns of the program:
Many people experiencing a loss may be encouraged by reading your feedback. Do you give Sierra Pregnancy + Health permission to share any part of your evaluation on our website or social media?
Yes, and you may include my first name
Yes, but please do not use my name (anonymous)
No, please do not share
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