Please provide your honest and candid feedback about the helpfulness of bereavement support services provided to you after the loss of your loved one. 1. Bereavement mailings provided helpful information and support.* Strongly DISAGREE DISAGREE Neither agree nor disagree AGREE Strongly AGREE Did not receive mailings 1a. The amount of bereavement mailings received was:* Too few About right Too many 2. After the death of your loved one, did you receive telephone calls from the bereavement program?* Yes No 2a. The number of bereavement telephone calls I received was:* Too few About right Too many 2b. Overall, how helpful was the telephone support you received from the bereavement program* Not helpful Somewhat helpful Very helpful 3. After the death of your loved one, did you call the bereavement program for information or support?* Yes No 3a. A counselor followed up with me in a timely manner* Strongly DISAGREE DISAGREE Neither agree nor disagree AGREE Strongly AGREE 4. After the death of your loved one, did you meet with a counselor from the bereavement program either in person or virtually?* Yes No 4a. How helpful was the individual counseling support?* Not helpful Somewhat helpful Very helpful 5. After the death of your loved one, did you attend any support groups or educational programs provided by the Hospice bereavement program?* Yes No 5a. How helpful were the grief groups or programs you attended?* Not helpful Somewhat helpful Very helpful 6. Overall, how well did the bereavement services meet your needs after the death?* Not very well Somewhat Very well 7. If there is anything else you would like to share about our bereavement services, please tell us below. Δ
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