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