Self-Care Challenge Evaluation Form

We appreciate your participation in the Self-Care Challenge! Your feedback is invaluable to us. Please take a few moments to complete this evaluation form to help us understand your experience and the impact of the challenge on your wellness journey.

First name*

Last name*

Email*

Phone

Occupation*

Location*

On a scale of 1-10, how would you rate your overall experience with the Self-Care Challenge? (1 being the lowest, 10 being the highest) *

1-2

3-4

5-6

7-8

9-10

Which day(s) of the challenge did you find most impactful? (Select all that apply) - - - *

Day 1: Physical Wellness

Day 2: Emotional Wellness

Day 3: Mental Wellness

Day 5: Social Wellness

Day 5: Spiritual Wellness

Please share any specific activities or practices that were particularly helpful for you:

Please share any additional comments or expectations you have for this challenge:

Thank you for participating in the Self-Care Challenge and for taking the time to complete this evaluation. Your feedback is invaluable to us as we strive to support and empower Black women in their wellness journeys. If you have any additional comments or stories you'd like to share, please do so below.

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TERMS & CONDITIONS

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TERMS & CONDITIONS

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