Occupational Health Feedback Form

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Feedback Form (Occupational Health)

Your views are important to us. Please complete this form to help the Blood Pressure Association evaluate the success of Know your Numbers! Week 2011 and improve the event in the future.

You must fill in boxes marked *

Your Name:
*

Your Job Title:
*

1st line of Pressure Station address:
*

Pressure Station Postcode
*

1. Why did you take part in the event?
Please check all boxes that apply:

To improve health of employees
To help demonstrate Corporate Social Responsibility
To raise awareness of high blood pressure among staff
To raise awareness of Occupational Health Services offered within/ to organisation
Other

If 'other', please specify:

2. Did taking part in the event increase the number of people visiting Occupational Health?

Yes
No

3. Did you raise the profile of / awareness about your services as a result of taking part in Know your Numbers! Week?

Yes
No

4. Please check the appropriate box to indicate which resource pack components you used during your event:

5. Did your Pressure Station combine blood pressure testing with any of the following testing or promotion of services?

If you ticked yes to 'Other', please state:

6. Did you promote your event in any of the following ways, in addition to any promotion conducted by the Blood Pressure Association?
(If 'none', please answer question 7)

In the media
Using posters or flyers to advertise your event
Online flyer
None

7. What were your reasons for not promoting your event?

8. How many more blood pressure checks did you carry out during Know your Numbers! Week, than in an average week?
(approximate figures will suffice)

9. In general, how well do you feel that people visiting your Pressure Station understood blood pressure before you gave them information?

No knowledge of high blood pressure
Some knowledge of high blood pressure
Extensive knowledge of high blood pressure

10. The Blood Pressure Association is a charity and needs continued financial support to carry out its work. Which, if any, of the following fundraising activities would you like more information on as a means of contributing to the work of the Blood Pressure Association?
Please check all boxes that apply:

10a. If your organisation is interested in supporting other fundraising activities, who would be the most appropriate person to contact?

Name:

Job Title:

Email:

Telephone Number:

11. Overall, do you feel that your participation in Know your Numbers! Week was successful?

Yes
No

12. Would you participate again next year?

Yes
No

13. How would you like to help with blood pressure initiatives from the Blood Pressure Association in the future?
Please check all that apply to you:

An additional Blood Pressure Association Know your Numbers! blood pressure testing event at a different time of year
Information materials aimed at groups at a greater risk of developing high blood pressure
General information on high blood pressure to give to staff
Do not wish to undertake other activities

14. Did you find people with raised blood pressure readings?

Yes
No

15. Do you know of anyone who had a raised reading that was picked up during Know your Numbers! Week and has since been diagnosed with high blood pressure?
If so, we would like to contact you to discuss how they might be able to share their story to help others

Yes
No

Please give a brief statement to summarise your thoughts on taking part in Know your Numbers! Week, including any particular successes, surprising findings or ways in which you think the event helped your patients/ customers/ staff/ members

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© Blood Pressure Association 2008
Registered as a Charity in England and Wales. Charity No: 1058944
Registered as a Company limited by guarantee in England and Wales. Company No: 03251531
Registered Office: 60 Cranmer Terrace, London. SW17 0QS produced by jamkit