UWIAB Participants Data Collection Advance Care Planning in Canada InitiativeName of Event:* I am:* Male Female Other I am from (town/province):* I am interested in ACP because of my role as (Select all the items that apply):* Personal Use Policy Maker Educator Seniors Support Long Term Care Worker Community/Home Care Worker Caregiver Clinician/Medical Program Developer Patient Advocacy Lawyer Other : Other : Please help us evaluate this event and the tools presentedHow likely are you to recommend this workshop?* 1 (Not At All) 2 3 4 5 (Extremely) How clear were the objectives of this workshop?* 1 (Not At All) 2 3 4 5 (Extremely) How would you rate the quality of tools provided (handouts, resources, etc)?* 1 (Poor) 2 3 4 5 (Excellent) How organized was the workshop?* 1 (Not At All) 2 3 4 5 (Extremely) Additional Comments:Would you be willing to allow the workshop organizers and ACP to contact you at a later date for a brief survey on the impacts of our tools and training sessions? If so, please provide your contact information below:Name First Last Phone :Email : NameThis field is for validation purposes and should be left unchanged.