End of Program Survey

End of Program Survey
Name
Optional
Date of Completed Program

MonthDayYear
Date of Survey

MonthDayYear
Group Type

Spousal LossParent LossFamily Loss
Group Location

Agoura HillsEncinoThousand OaksWest Los Angeles
Sharing your experience in the grief support groups will help us to help others in their time of need. Please answer the following questions about your experience.

HOPE Connection Group Experience

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The grief group sessions helped me
I now understand my own grief journey better
The group taught me ways to cope with my grief
I felt accepted and understood by the group members
I felt less alone in my grief because of the groups
I have become more sensitive to the needs of other bereaved people and feel that I can reach out and support others
I learned to be more self-compassionate

HOPE Connection Therapists

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The group therapists did an effective job
The group therapists were warm and caring
The group therapists educated me about grief and healing
The group therapists gave me hope that I’d heal
The group therapists gave me handouts that helped

Social Aspects of the HOPE Program

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
In the group, I made new friends that understand
I am open to new relationships

Acceptance

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I now feel okay when I’m alone
I am more accepting of my changed life
I socialize with people outside of group

Overall

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I had a positive experience in the HOPE groups
I am willing to refer bereaved individuals to HOPE
I feel that I have healed enough to create my new life
Overall, I am satisfied with my experience with the HOPE Connection program

Additional Comments
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Mailing Address: P.O. Box 774, Agoura Hills, CA 91376
Email: info@hopegroups.org - Website: www.hopegroups.org
Phone: 818-788-HOPE - Fax: (877) 351-2003
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