Please help us to serve you better by completing this survey. It should take around 5 minutes to complete.

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Program Evaluation

On a scale of 1 - 4 please rate the following

• Wait time before starting cardiac rehabilitation
  PoorFairGoodExcellent
• Duration of the program (6 months)
  PoorFairGoodExcellent
• Program facilities (accessible, clean, functional)
  PoorFairGoodExcellent
• Professionalism and knowledge displayed by program staff
  PoorFairGoodExcellent
• Access to additional resources (dietitian, certified tobacco educator, community resources – Diabetes Education, etc.)
  PoorFairGoodExcellent
• Helpfulness of program volunteers
  PoorFairGoodExcellentN/A
• Content of weekly in-class education sessions
  PoorFairGoodExcellent
• Content of educational handouts
  PoorFairGoodExcellent
• Overall program satisfaction
  PoorFairGoodExcellent

Personal Achievements

On a scale of 1 - 4 please rate the following

• Improvement in exercise endurance
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Improvement in ability to perform activities of daily living
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Improvement in self-confidence
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Improvement in knowledge of how to modify risk factors for cardiovascular disease
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Improvement in satisfaction of social activities
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Improvement in satisfaction of recreational activities
  N/AUnsatisfiedSomewhat SatisfiedSatisfied

Change in Cardiovascular Disease Risk Factors

On a scale of 1 - 4 please rate the following

• Waist measurement
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Cholesterol
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Diabetes
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Blood pressure
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Eating habits and dietary intake
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Smoking
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Stress and coping behaviours
  N/AUnsatisfiedSomewhat SatisfiedSatisfied
• Active Lifestyle
  N/AUnsatisfiedSomewhat SatisfiedSatisfied

Please make any additional comments and/or suggestions below: