Wellness Grant Exit Survey

Name*

First Last

Please provide your telephone number or email address:*

Please provide today's date for our records:*

Briefly describe the nature of the service for which the grant funding was used.*

How did the grant funding help you reach your expected outcomes?*

Please rank the following statements.

How helpful was this grant in supporting your health and wellness goals?*

To what degree did you meet your expected outcomes during the course of the grant period?*

To what degree has participating in this grant enhanced your quality of life?*

How easy was the grant application process?*

From your experience, how easy did you find the reimbursement/payment process?*

Was the grant amount adequate to support you in your health/wellness pursuits?*

Do have any suggestions for the wellness grant regarding the application process, the disbursement of funds, or grant guidelines/requirements?*

Do you intend to apply for the grant if it is offered again in 2020?*

I have participated in a minimum of one I AM activity or meeting in the course of the grant period.*

I have participated in fundraising for I AM in some capacity, as outlined in the grant guidelines.*

Testimonial:

Photos:

Max. file size: 256 MB.

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