Date of the course (required)

    Course Location or Group Name

    Gender MaleFemaleOtherPrefer not to say

    Age under 2122-3435-4445-5455-64over 65

    Have you attended a previous Heartstart course?
    YesNo

    What do you think about
    The presentation of the courseExcellentGoodFairPoor
    The teaching aids used          ExcellentGoodFairPoor
    The Response to questions     ExcellentGoodFairPoor

    Would you recommend the course to others?
    YesNo

    Was the room suitable?
    YesNo
    If No please explain

    Did you find anything difficult?
    YesNo
    If Yes please explain

    Any other comments