Men's Support Group Interest Survey
In an effort to serve male stroke survivors better, Stroke Awareness Oregon (SAO) is pleased to send this confidential questionnaire. Please review and give your honest answers for us to create significant meetings that will help you and your family the best as you move forward in your health.
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Would you be more likely to attend a Stroke Survivor Meeting if it were for males only? *
How often would you prefer to get together?
Clear selection
What is your best day for a meeting?
Clear selection
What is your best time for a meeting?
Clear selection
Would you prefer to meet via online using a video conference tool like Zoom?
Clear selection
Should there be an agenda for each meeting?
Clear selection
How often would you like to listen to a speaker talk?
Clear selection
Would you have an interest in supplying ideas for the meeting(s)?
Clear selection
What is your preferred learning skill?
Clear selection
How long should the meetings last?
Would you enjoy meeting in a private room at a brewery, restaurant or coffee house instead of the hospital?
Clear selection
What are your most frustrating challenges? (Please choose a minimum of the top 3. Write your most frustrating challenge on the "other" line.)
Would you appreciate a format where you could talk with other male stroke survivors confidently about personal feelings that you may not want to share with family members?
Clear selection
Would you want your caregiver and/or support person to be a part of this meeting (this person could be on-site, but not be involved in the meeting room)?
Clear selection
What specific ideas would you like to talk about in upcoming meetings?
Other ideas are greatly appreciated
Name and phone number (optional)
Email address (optional)
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