Name (optional)
              
             
          
                
                
                  
                    First Name 
                   
                
                
                  
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              I found the enrollment process and website easy to navigate.
              
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                    Yes 
                  
                    No 
                  
                    Could use improvement. 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              How would you rate your overall experience with the program from 1 to 10, with 10 being the highest in satisfaction?
              
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                    10 
                  
                    9 
                  
                    8 
                  
                    7 
                  
                    6 
                  
                    5 
                  
                    4 
                  
                    3 
                  
                    2 
                  
                    1 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Program Descriptions
              
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                Select the TOP 3-4 words you might use to describe this support group:
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              What exercise(s) were most helpful in shifting your grief or trauma?
              
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                Select all that apply.
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              What exercise(s) were least helpful in shifting your grief or trauma?
              
             
          
                Select all that apply.
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              How likely are you to continue access to your Rewire Therapy website login?
              
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                    Very Likely. 
                  
                    Maybe Sometimes? 
                  
                    Not Likely. 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              FOR GROUPS: Did you leave feeling connected to and supported by the other participants in the group after Week 8?
              
             
          
                
                
                
                  
                    Yes, absolutely. 
                  
                    Sort of. 
                  
                    Not really. 
                  
                    Other/Something else 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Would you be interested in attending a future reunion for participants that have taken the WayFinders Program?
              
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                    Yes 
                  
                    No 
                  
                    Maybe 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Additional Feedback for Rebecca Mullins:
              
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                Please share any feedback or thoughts about your experience working with Rebecca.
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Additional Feedback for Co-Facilitator (if applicable):
              
             
          
                FOR GROUPS: Please share any feedback or thoughts about your experience working with the co-facilitator:
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Any parting thoughts or feelings you'd like to share with us?
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Online Reviews?
              
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                I would be willing to write a review about the WayFinders to help others find support: