This evaluation form asks participants of a health and wellbeing course called "Ready Steady for adults Form" to rate their physical and mental health before and after taking the course. It also asks whether their health has improved in areas like alcohol awareness, smoking awareness, cooking habits, nutrition knowledge, and motivation. Participants are further asked to rate feelings like stress, confidence, and health knowledge on scales of 1 to 7 both before and after the course. The form collects feedback on the most and least liked parts of the course to help the program improve.

1. Ready Steady for adults Form
EVALUATION FORM
Please tell us how this activity has impacted on your health and wellbeing.
Name:
Date:
Please circle number:
Overall how do you rate your physical health 1 2 3 4 5 6 7
and wellbeing before the course?
Overall how do you rate your physical health 1 2 3 4 5 6 7
and wellbeing since doing the course?
Overall, how do you rate your mental health 1 2 3 4 5 6 7
and wellbeing before doing the course?
Overall, how do you rate your mental health 1 2 3 4 5 6 7
and wellbeing since doing the course?
Do you believe your health has improved with reference to: Yes No Don’t know
• Alcohol awareness
• Smoking awareness
Has the HALE course affected you in any of the following ways?
Please tick Yes No Don’t know
Do you feel more confident about cooking your own food, since
being on this course?
Are you aware of eating more healthily since attending this
course?
Do you feel more informed about salt intake?
Has the course given you any new ideas of healthy snacks?
Has the course had a positive impact on your family’s health?
Do you think twice about cooking your own food rather than
buying a takeaway?
Has the course increased your self esteem?
Are you motivated to continue to improve your health?
Please tick 3 significant changes you have made / learnt as a result of attending this course
1.
2.
3.

2. To help us ensure that we are supporting people in as full a way as possible, please fill the scores in
below.
Before the course
On a scale of 1-7 please circle the score that best describes how you feel since attending this
course.
Unhappy 1-----2-----3------4------5------6------7 Happy
Stressed 1-----2-----3------4------5------6------7 Calm / relaxed
Out of control of my emotions 1-----2-----3------4------5------6------7 in control of my emotions
Lack of motivation 1-----2-----3------4------5------6------7 motivated
No self confidence 1-----2-----3------4------5------6------7 Confident
Unable to cope with problems 1-----2-----3------4------5------6------7 coping with problems
Don’t look after myself 1-----2-----3------4------5------6------7 able to look after myself
I don’t relate well to people 1-----2-----3------4------5------6------7 I relate well to people
I don’t feel informed about health issues 1-----2-----3------4------5------6------7 I feel informed about health
issues
After the course
On a scale of 1-7 please circle the score that best describes how you feel since attending this
course.
Unhappy 1-----2-----3------4------5------6------7 Happy
Stressed 1-----2-----3------4------5------6------7 Calm / relaxed
Out of control of my emotions 1-----2-----3------4------5------6------7 in control of my emotions
Lack of motivation 1-----2-----3------4------5------6------7 motivated
No self confidence 1-----2-----3------4------5------6------7 Confident
Unable to cope with problems 1-----2-----3------4------5------6------7 coping with problems
Don’t look after myself 1-----2-----3------4------5------6------7 able to look after myself
I don’t relate well to people 1-----2-----3------4------5------6------7 I relate well to people

3. I don’t feel informed about health issues 1-----2-----3------4------5------6------7 I feel informed about health
issues
What did you like most about this course?
What did you like least about this course?
Thank you for taking time to complete this evaluation. It is very important to us and
will contribute to improving the way HALE delivers its activities