Feedback Form

Host & Participant Feedback Form

Date of event: _____________________
Host(s): _______________________________________________
City: _________________
State: ______

1. Why did you say “yes” to participate in the conversation?
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2. What was most satisfying, enriching, or valuable about your experience in this conversation?
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3. What was less than satisfying, frustrating, or challenging?
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4. What did you learn or find interesting about the concerns of others in the group?
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5. What did you learn that was new to you about this issue or other important subjects?
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6. Is there anything else about having participated in this Living Room Conversation that you appreciated or consider an accomplishment?
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7. What advice or suggestions can you offer to people designing future conversations on this issue?
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8. Other comments?
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9. May we share your feedback publically as first-hand experience with the Living Room Conversations project?
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10. Would you consider hosting a similar gathering and encourage family and / or friends to participate in a Living Room Conversation?
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11. May Living Room Conversations contact you for further feedback?
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Name (optional): ____________________________________________
Email: ____________________________________________________
Phone: ________________________________Privacy statement: Your contact information, including name, email and phone number will be used only for the purpose of gathering your feedback.