Participant Satisfaction Survey

Please help us improve the quality of our services for people with cancer and their loved ones by providing feedback about your experience at The Wellness Community of Philadelphia (TWCP).

1. Your participation at TWCP has been as a:

	Person with cancer
	Support person
	Other:

2. You have participated in TWCP groups/programs at:

	Suzanne Morgan Center at Ridgeland - Fairmount Park
	Anne McCouch Center in Lansdale
	Off-Site (Paoli Cancer Center)
	Community-Based Sites (Einstein Cancer Center, Temple University Hospital, Family Practice & Counseling Network, Haddington Multi-Services for Older Adults, Mercy Hospital of Philadelphia or Tindley Temple United Methodist Church)
	Other:

3. What is the stage of your (or your loved one's) cancer?

	Newly diagnosed
	In remission
	Advanced or metastatic
	Other:

PROGRAM EXPERIENCE

4. Please identify which of the program(s) you have attended in the past year and how often:

	Never	1-4 times	5-9 times	10 times or more
Support Groups
Newcomers Meeting
Mind-Body Basics/Series
Tai Chi, Yoga, Qi Gong
Exercise Classes
Educational Workshops
Social Events
Networking Group (thyroid, lung, IBC, etc.)
Journaling, Music, Art
Other (Please Specify Below):

5. How long have you been attending programs at The Wellness Community of Philadelphia?

6. Which of the following describes what you feel you have gained from attending programs at The Wellness Community of Philadelphia? (Check all that apply)

OVERALL EXPERIENCE

7. Please rate the quality of your experience with programs at The Wellness Community of Philadelphia in the areas listed below. (1 = poor, 5 = outstanding)

	1	2	3	4	5
Your first contact with TWC
The general atmosphere, furnishings, etc.
Location and accessibility
TWC employees and volunteers
Quality/variety of programs
Professionalism of instructors
Readability/availability of calendar

8. How can we improve our services?

9. Please feel welcome to share any other comments.

	Decreased psychological distress (i.e. depression, anxiety, stress)
	Increased quality of life (physical, emotional, social, spiritual, etc.)
	Access to information about cancer and its treatment
	Increased participation in treatment planning with my health care team
	New attitude toward the illness and/or treatment
	Increased feelings of hope
	Increased feelings of control
	Feeling less alone
	Connection with others who share similar concerns
	Other (Please Specify Below)