1. Peer Support Group Survey
It is very important to
Peer Support and March of Dimes Canada to
improve our services to our
Support Groups and their members.
To help us improve our services
We need information
that only you can provide.
The information you provide
Will be confidential

2. Information from the surveys
will be presented in summary form only.
The survey is voluntary and
your responses will
help improve services for
peer support groups across Ontario.
We look forward to learning
what you think about
the March of Dimes Canada
peer support program.
About you
Name: _________________________
Address: _____________________________
Phone: ___________ ______________
Name of Support Group:
_____________________________________

3. 1. How often does your support group meet?
More than once a month
Once a month
Once a week
Every 3 to 6 months
Other: _____________________
2. How Often do you come to group meetings?
Less than half
Approximately one half
More than one half
Other:____________________________
3. How often do you think
your support group should meet?
More than once a month
Once a month
Every other month
Every 3 to 6 months
Other: ____________________

4. 4. How long does it take you to travel to the location of your support group meeting?
Less than 15 minutes
15 to 30 minutes
30 to 60 minutes
More than 60 minutes
5. What difficulties do you face
in going to support group meetings?
Distance
Transit
Fatigue
Communication
Other:______________________
6. My support group has made
a significant difference in my life.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

5. 7. What are the main reasons you go to support group meetings?
Peer Support / Socialization
Current events / Announcements
Guest Speakers
Information / Education
Other:________________________
8. What activities do you enjoy the most
at support group meetings?
Peer Support / Socialization
Current Events / Announcements
Guest Speakers
Information / Education
Conversation and Discussion
Other:_______________________

6. 9. Which of the following activities
are provided by your support group?
(check all that apply)
Education
Socialization and Conversation
Fundraising
Hosting conference(s)
Guest speakers
Community awareness/visitation
Daytrips/Excursions
Other: ______________________
Are there activities you would like to have
offered that are not currently provided by
your support group?
Leadership training
Supportive Communication Training / Education
Community awareness/visitation
Daytrips/Excursions
Other: ______________________

7. What have you found most helpful
about your support group?
Peer Support
Current Events / Announcements
Guest Speakers / Education
Reading / Writing practice
Opportunity for Conversation
Other:________________________
13. What have you found least helpful
about your support group?
Peer Support
Current Events / Announcements
Guest Speakers / Education
Reading / Writing opportunities
Group size ( too big or too small)
Opportunity for conversation
Other:__________________________

8. Would you be interested in Volunteering with this Peer support group
Would you be interested in Volunteering with this Peer support group? Please check any positions that interest you:
Chairperson
Vice Chair
Secretary
Treasurer
Key Worder /Communication Facilitator
Preparing Refreshments
Other:______________

9. Now we would like to ask you about March of Dimes Canada and the support and/or services it provides to your support group.
15. Do you feel Peer Support/March of Dimes Canada meets the needs of your support group?
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Don’t know
Which of the following services offered by
March of Dimes Canada are you aware of?
DesignAbility®
Aphasia Camp
Warmline
Peer Support Travel
Walk and Roll
Highlights Publication
Aphasia /Communication Program
Other: ______________________

10. to complete this survey. Your information will help us to
How could Peer Support/March of Dimes
Canada better prepare you to serve your group’s needs?
Leadership training
Key wording Training / Education
Community awareness/visitation
Daytrips/Excursions
Other: ______________________
18. I am interested in receiving more
information about the programs and
services offered.
Yes No
Thank you for agreeing
to complete this survey.
Your information will help us to
improve your support group experience.