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Home
Health
2022 Hypertension Workshops
Program Evaluation
Hypertension Workshop Evaluation
Program Evaluation
1
2
3
4
Session
*
3/28/2022 – Blood Pressure Classifications
4/11/2022 – Self-Measurement of Blood Pressure
4/25/2022 – Lifestyle Modifications
5/9/2022 – High Blood Pressure & Pharmacology
5/23/2022 – Adherence to High Blood Pressure Therapy
6/6/2022 – Hypertension Emergencies and Urgencies
Please select the session you are evaluating.
Demographic Information
Please complete this form only if you have been diagnosed with high blood pressure. If you attended as a significant other, thank you for coming but do not complete this form.
Gender
*
Male
Female
Other
Age
*
20-21
22-34
35-49
50-64
65+
Race
*
Non-Hispanic Origin
Hispanic by Race
Race – Non-Hispanic Origin
*
White
Black
Asian/PI
American Indian
Other/Unknown
Race – Hispanic by Race
*
White
Black
Other/Unknown
Program Questions
Which blood pressure reading is considered "normal"?
*
110/60 mmHg
120/80 mmHg
140/90 mmHg
150/100 mmHg
Which blood pressure reading is considered "hypertensive" or high blood pressure? Select all that apply.
*
110/60 mmHg
120/80 mmHg
140/90 mmHg
150/100 mmHg
List three (3) things you can do to help lower your blood pressure:
*
Are you following health care provider directed action to control your high blood pressure?
*
No
Yes, changing my lifestyle
Yes, taking medications
Yes, both lifestyle changes and medications.
Is your blood pressure now under control?
*
No
Yes
I don’t know
Are you currently measuring your Blood Pressure at home?
*
Yes
No
If yes, how many times per week do you check your blood pressure and record the reading?
*
Have you shared or do you plan to share your Blood Pressure readings with your health care provider?
*
Yes
No
Program Evaluation
On a scale of 1 to 5, please evaluate the overall program.
The program inforatmion was interesting
*
1 = Strongly Disagree, 3 = Agree, 5 = Strongly Agree
1
2
3
4
5
The program information was organized and clear
*
1 = Strongly Disagree, 3 = Agree, 5 = Strongly Agree
1
2
3
4
5
The program increased your knowlege.
*
1 = Strongly Disagree, 3 = Agree, 5 = Strongly Agree
1
2
3
4
5
Were your questions answered satisfactorly?
*
Yes
No
Did you feel free to ask questions and discuss issues of importance to you during the program?
Yes
No
Do you feel that the information provided and skills practiced will help you control your blood pressure?
*
Yes
No
Did you find the handout materials useful?
*
Yes
No
Was the time of the program convenient?
*
Yes
No
Was the length of the program appropriate?
*
Yes
No
What were the most and least valuable content areas of the program?
*
Do you have any suggestions that you believe would improve the self-care program?
*
Where did you hear about the program?
*
Social Media
Website
Town of Windsor Staff
Poster / Flyer
Doctor
Word of Mouth
Other
I enjoyed using Zoom to attend this Hypertension Workshop:
*
Yes
No
I watched this program
*
Live
After it was recorded
I am a Medicaid recipient and am interested in using a self-monitoring blood pressure device, yet have not been able to get one. Someone from the Windsor Health Department will contact you.
Yes
Phone
*
Please enter your phone number so that the Windsor Health Department may contact you.
Are you a Windsor resident?
*
Yes
No
Name
*
First
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*
Street Address
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