GISA Feedback Survey | Healing the Wounds of Womanhood

First & Last Name *

Email Address *

1. How long did it take you to complete the Grief Inventory and Stress Assessment (GISA)? *

Less than 5 minutes

5-to-7 minutes

10 minutes or more

2. What was your Grief Inventory score? *

As a reminder, the Grief Inventory is the combined number of distinct memories you had for each topic on the GISA.

3. What was your Stress Level Assessment (the number of incidents with a SUDs level of 3 or higher)? *

As a reminder, the Stress Level number is the total number of incidents for the entire GISA that have a SUDs level of three (3) or higher.

4. Were the instructions clear for filling out the GISA? *

Yes

No

If you answered no to the question #4 above, please let us know how we could improve the instructions for the GISA.

5. Now that you've read the information in the handout and taken the GISA, how likely would you be to register for and participate in our Healing the Wounds of Womanhood program? *

(Where 10 is equal to "Where can I sign up right now?!!)

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