Event Feedback Form for Attendees
How old are you? (optional)
18-25
26-35
36-45
46-55
56-65
65+
What is your post code?
*
Name of event attended
*
Before this event, had you ever had a conversation about dying?
*
Yes
No
Do you personally know someone who is dying or has died?
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Yes
No
How did you feel before coming into the event/expo?
After attending, how are you feeling now?
What is one thing you found out at this event that you didn’t know already?
*
As a result of this event, do you think you will feel more comfortable having conversations about death and dying with others: (5 much more comfortable - 0 not at all comfortable)
0
1
2
3
4
5
As a result of this event, can you name 3 different types of people that can help with dying?
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Yes
No
If yes, please name those 3 types of people.
Would you like to be involved in supporting someone who is dying?
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Yes
No
If yes, what kind of support would you like to offer?
Providing help around the home
Personal care for the person dying (bathing, dressing, lifting)
Cooking meals
Bringing flowers
Visiting the person who is dying
Helping to fundraise if required
Taking the children to school and other activities
Capturing the stories of the person who is dying before they are gone
Supporting friends and family
Photographing family and friends as a keepsake
Helping to plan the funeral and the wake
Other
If you've thought about the process of dying, what would be most important to you? (select top two)
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Being with family and friends
Getting the best medical care
Not being in pain
As little medical intervention as possible
Leaving a legacy
Dying in the place of my choice
Has attending this gathering made you more likely to talk to someone about your end of life wishes?
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Yes
No
Would you recommend a Dying to Know event to a friend/family member?
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Yes
No
Maybe
Not sure
What topics would you like covered in future events?
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