IM&M+ Participant Evaluation – In Motion & Momentum+

What was the name of the delivery site where you completed IM&M+?

When did you completed IM&M+?

Please complete the chart below.

For each statement, begin by reading the statement. Reflect on how you feel now and click on a number between 1 and 5.

Then, consider how you felt before attending IM&M+ and click the correct number between 1 and 5.

1 = Not at all 2 = A little 3 = Some 4 = Quite a bit 5 = Totally

Looking back to BEFORE I started this program, I was feeling…

NOW that I’ve completed this program, I am feeling…

How I feel about myself

I can have happy moments - it is not all or nothing

I can be healthy in parts of my life

I have some skills, strengths and abilities.

I have some control in my life

I can work well with others

How I feel about those around me and my community

I have some people who are really on my side

I feel confident seeking support services if I need them

I can make a difference (in my own life, my family, my community)

I use support services in my community i.e. employment services, housing supports, mental health services, etc.

I use support services in my community i.e. employment services, housing supports, mental health services, etc. - BEFORE

I use support services in my community i.e. employment services, housing supports, mental health services, etc. - AFTER

I feel proud about the role I play in the community

How I feel about my future

I can recover from failure - it can move me forward

I feel in control of my future

I am willing to take small risks

I am taking the steps needed to move forward

I can see exciting possibilities for myself when I think about the future

If you feel there have been positive changes in your life, how much of that change is because of this series?

The changes are mostly because of this series

The changes are partly because of this series

The changes have nothing to do with this series

What I liked best about this series was...

What I liked least about this series was...

Would you recommend this program to someone else?

Yes

I’ve already recommended it to someone

If you are human, leave this field blank.