Awhi Community Evaluation Form

Awhi Community is made possible through the support of some generous IHC donors. Given this, we need to evaluate how the donations are spent and if the funding addresses the needs of individuals and / or families. To help us with the evaluation, could you, the referrer, please take a few minutes to completed the below questions. Thank you.

Referrer Contact Information

As the referrer, please provide your name and contact details. Thank you.

Contact Details

Recipient's Contact Information

Please provide the name for the individual / family you referred. Thank you.

Contact Details

Evaluation Questions

Please provide as much information as possible to help us complete the evaluation process. Thank you.

What did Awhi Community provide funding for?
What was the value of the funding?
How did the funding impact the individual / family?
Did the funding address the critical need for the individual / meeting?
Did the funding improve overall quality of life or promote independence for the individual / family??

Additional Information

Do you have any additional information you would like to share? This could be from the individual / family or even photos?

If you have any images to share, please upload these below.

Thank you, if we require any further information, we will be in touch.

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