Service/Program information
Service/Program name/title: *
Developed by: (person/organisation)
Year developed:
Service/Program Description
Aim/s: *
Target group:
Brief description of program
(e.g. number of sessions, duration/time, delivery format, location etc)
Evaluation information
Description of the evaluation process:
Who undertook the evaluation?
Is an evaluation report available? *
Yes
Available from:
No
Were you satisfied with the evaluation methodology and method used?
Yes
No
If No, what would you recommend for future evaluations of a similar nature?
Were there barriers/difficulties experienced in carrying out the evaluation? Please describe:
Any other information relating to the evaluation? Please comment:
Contact information
Information submitted by: (name/contact person) *
Organisation:
Address:
Thank you for taking the time to complete this form. All information provided
will be listed on the AICAFMHA website as a reference for workers with an
interest in the development and implementation of programs and services for
children of parents with a mental illness and their families.