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

    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: