Evaluation Survey 2

For a sample of program outcomes. Click here.

PERFORMANCE VENUE:                                                                             FUNDING BODY/CONTACT NAME:                                                                         DATE:

In thinking about your most recent experience with Mind Blank were you satisfied with your experience? If not, why?


Were you happy with the customer service received from our Performance Coordinator?


Was our “End Message” clear and defined that there is help and support available?


Do you have any recommendations or room for improvements?


Please comment on any evaluations you may have received after our performance/s


Would you consider booking the Mind Blank crew in the future?


To assist Mind Blank in meeting the needs of local communities relating to Mental Health issues could you please answer the following

What mental health issues are prevalent in your area?


For the development of additional Mind Blank scripts, what Mental Health topics would you suggest?

• Anxiety                      • Bipolar                      • Body Image            • Cyber Bullying

• Depression               • Domestic Violence  • Self-Harm                • Stress

• Other: _____________________________________________________________

Would you or your organisation be interested in helping our team with a letter of support to assist us in lobbying for further funding opportunities?

                                                           • Yes                      • No

Would you like us to put forward your school for funding support?    • Yes               • No

I give my permission for data included in this survey to be directly quoted or made public to promote Mind Blank and further secure funding opportunities.

If you DO NOT want this information to be used for this purpose, please tick box below.  •    No