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EASE Participant Evaluation

Name
MM slash DD slash YYYY
MM slash DD slash YYYY

Thank you for participating in the EASE program at Quantum Leap Farm. We would appreciate it if you would take a few minutes to tell us about your experience at the Farm so far. Please circle the response that best describes your feelings. Thank you for your help!

1) Participating in the EASE sessions at Quantum Leap Farm has helped me improve my emotional well-being.
2) Participating in the EASE sessions at Quantum Leap Farm has helped me improve my self-confidence.
3) Participating in the EASE sessions at Quantum Leap Farm has helped me explore my current coping skills and consider productive alternatives.
4) Participating in the EASE sessions at Quantum Leap Farm has helped me manage the stress in my life.
5) I believe that participating in services at Quantum Leap Farm has improved my quality of life.
6) I believe that when I participate in services at Quantum Leap Farm I am safe.
7) I am very satisfied by the services I receive at Quantum Leap Farm.
8) I believe that participating in services at Quantum Leap Farm has had a positive impact on my daily living.

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