Pain Management Class: Final Session Feedback Form

Source: physio4gps Pain Management Classes
Document type: participant feedback
Review status: unreviewed

Original file: Pain Management - FInal Session Feedback (June 26)(2).docx

PARTICIPANT FEEDBACK

Pain Management Class - Final session feedback

Name

Date of birth

Registered Practice

..... /...... / ................. /...... / ............

..... /...... / ............

..... /...... / ............

Thank you for attending our pain management sessions. We hope you found them helpful. Please complete this feedback form and return it to a member of staff to help us improve future sessions.

Statement – please rate on a scale of 1 – 5, 1 = strongly disagree, 2= disagree, 3= neutral, 4 = agree, 5 = strongly agree

I found the pain management sessions to be useful.

1

2

3

4

5

I now better understand my pain than before the sessions.

1

2

3

4

5

I am now able to manage my pain better than before the sessions.

1

2

3

4

5

Using the same scale, please rate each of the sessions you have attended of this course.

Week 1: Education Session

1

2

3

4

5

Week 2: Mental Health

1

2

3

4

5

Week 3: Yoga & Physiotherapy Session

1

2

3

4

5

Week 4: Pharmacy Session

1

2

3

4

5

Week 5: Physiotherapy & Meditation – Final Reflection

1

2

3

4

5

Please circle your current pain level, following completion of this course, on a scale of 1–10 with 10 being the worst:

1 2 3 4 5 6 7 8 9 10

Given the opportunity, would you attend this course again if required?

Yes No

Please let us know if you have any further comments:

Thank you for giving your feedback and for attending the sessions, we wish you the very best for the future.

About this document. This page reproduces a source document from the physio4gps group pain-management programme. It is transcribed from the file supplied by the programme: page and slide markers have been removed and multi-column sections reflowed, so reading order in some sections may differ from the original layout. Where text was illegible or clipped in the source this is stated in place. Identifying details are left as in the original. This is reference material, not clinical advice, and it has not been clinically reviewed.