San Mateo County Asthma Coalition Survey

We are interested in hearing about your perspectives on how San Mateo County Asthma Coalition is doing! Please select the response that best shows your opinion with each aspect of the Coalition. Thanks!

*This survey was adapted from CoalitionsWork's Coalition Member Survey

	Strongly Disagree	Disagree	Agree	Strongly Agree	Not Applicable
I understand the direction of the Coalition's vision	I understand the direction of the Coalition's vision Strongly Disagree	I understand the direction of the Coalition's vision Disagree	I understand the direction of the Coalition's vision Agree	I understand the direction of the Coalition's vision Strongly Agree	I understand the direction of the Coalition's vision Not Applicable
The staff provides training and technical assistance to me or my organization	The staff provides training and technical assistance to me or my organization Strongly Disagree	The staff provides training and technical assistance to me or my organization Disagree	The staff provides training and technical assistance to me or my organization Agree	The staff provides training and technical assistance to me or my organization Strongly Agree	The staff provides training and technical assistance to me or my organization Not Applicable
I am satisfied with the e-newsletters I receive.	I am satisfied with the e-newsletters I receive. Strongly Disagree	I am satisfied with the e-newsletters I receive. Disagree	I am satisfied with the e-newsletters I receive. Agree	I am satisfied with the e-newsletters I receive. Strongly Agree	I am satisfied with the e-newsletters I receive. Not Applicable
I was satisfied with the planning process used to prepare Coalition's scope of work	I was satisfied with the planning process used to prepare Coalition's scope of work Strongly Disagree	I was satisfied with the planning process used to prepare Coalition's scope of work Disagree	I was satisfied with the planning process used to prepare Coalition's scope of work Agree	I was satisfied with the planning process used to prepare Coalition's scope of work Strongly Agree	I was satisfied with the planning process used to prepare Coalition's scope of work Not Applicable
I am satisfied with the food that is being served at the meetings.	I am satisfied with the food that is being served at the meetings. Strongly Disagree	I am satisfied with the food that is being served at the meetings. Disagree	I am satisfied with the food that is being served at the meetings. Agree	I am satisfied with the food that is being served at the meetings. Strongly Agree	I am satisfied with the food that is being served at the meetings. Not Applicable
I am satisfied with the topics that are selected for the meetings	I am satisfied with the topics that are selected for the meetings Strongly Disagree	I am satisfied with the topics that are selected for the meetings Disagree	I am satisfied with the topics that are selected for the meetings Agree	I am satisfied with the topics that are selected for the meetings Strongly Agree	I am satisfied with the topics that are selected for the meetings Not Applicable

Strongly Disagree

Disagree

Agree

Strongly Agree

Not Applicable

I understand the direction of the Coalition's vision

I understand the direction of the Coalition's vision Strongly Disagree

I understand the direction of the Coalition's vision Disagree

I understand the direction of the Coalition's vision Agree

I understand the direction of the Coalition's vision Strongly Agree

I understand the direction of the Coalition's vision Not Applicable

The staff provides training and technical assistance to me or my organization

The staff provides training and technical assistance to me or my organization Strongly Disagree

The staff provides training and technical assistance to me or my organization Disagree

The staff provides training and technical assistance to me or my organization Agree

The staff provides training and technical assistance to me or my organization Strongly Agree

The staff provides training and technical assistance to me or my organization Not Applicable

I am satisfied with the e-newsletters I receive.

I am satisfied with the e-newsletters I receive. Strongly Disagree

I am satisfied with the e-newsletters I receive. Disagree

I am satisfied with the e-newsletters I receive. Agree

I am satisfied with the e-newsletters I receive. Strongly Agree

I am satisfied with the e-newsletters I receive. Not Applicable

I was satisfied with the planning process used to prepare Coalition's scope of work

I was satisfied with the planning process used to prepare Coalition's scope of work Strongly Disagree

I was satisfied with the planning process used to prepare Coalition's scope of work Disagree

I was satisfied with the planning process used to prepare Coalition's scope of work Agree

I was satisfied with the planning process used to prepare Coalition's scope of work Strongly Agree

I was satisfied with the planning process used to prepare Coalition's scope of work Not Applicable

I am satisfied with the food that is being served at the meetings.

I am satisfied with the food that is being served at the meetings. Strongly Disagree

I am satisfied with the food that is being served at the meetings. Disagree

I am satisfied with the food that is being served at the meetings. Agree

I am satisfied with the food that is being served at the meetings. Strongly Agree

I am satisfied with the food that is being served at the meetings. Not Applicable

I am satisfied with the topics that are selected for the meetings

I am satisfied with the topics that are selected for the meetings Strongly Disagree

I am satisfied with the topics that are selected for the meetings Disagree

I am satisfied with the topics that are selected for the meetings Agree

I am satisfied with the topics that are selected for the meetings Strongly Agree

I am satisfied with the topics that are selected for the meetings Not Applicable

	Strongly Disagree	Disagree	Agree	Strongly Agree	Not Applicable
I feel that that my opinion matters to the Coalition.	I feel that that my opinion matters to the Coalition. Strongly Disagree	I feel that that my opinion matters to the Coalition. Disagree	I feel that that my opinion matters to the Coalition. Agree	I feel that that my opinion matters to the Coalition. Strongly Agree	I feel that that my opinion matters to the Coalition. Not Applicable
I am able to network with other Coalition members.	I am able to network with other Coalition members. Strongly Disagree	I am able to network with other Coalition members. Disagree	I am able to network with other Coalition members. Agree	I am able to network with other Coalition members. Strongly Agree	I am able to network with other Coalition members. Not Applicable
I understand my purpose for being part of the Coalition.	I understand my purpose for being part of the Coalition. Strongly Disagree	I understand my purpose for being part of the Coalition. Disagree	I understand my purpose for being part of the Coalition. Agree	I understand my purpose for being part of the Coalition. Strongly Agree	I understand my purpose for being part of the Coalition. Not Applicable
I am able to help the Coalition meet its work plan objectives.	I am able to help the Coalition meet its work plan objectives. Strongly Disagree	I am able to help the Coalition meet its work plan objectives. Disagree	I am able to help the Coalition meet its work plan objectives. Agree	I am able to help the Coalition meet its work plan objectives. Strongly Agree	I am able to help the Coalition meet its work plan objectives. Not Applicable

Strongly Disagree

Disagree

Agree

Strongly Agree

Not Applicable

I feel that that my opinion matters to the Coalition.

I feel that that my opinion matters to the Coalition. Strongly Disagree

I feel that that my opinion matters to the Coalition. Disagree

I feel that that my opinion matters to the Coalition. Agree

I feel that that my opinion matters to the Coalition. Strongly Agree

I feel that that my opinion matters to the Coalition. Not Applicable

I am able to network with other Coalition members.

I am able to network with other Coalition members. Strongly Disagree

I am able to network with other Coalition members. Disagree

I am able to network with other Coalition members. Agree

I am able to network with other Coalition members. Strongly Agree

I am able to network with other Coalition members. Not Applicable

I understand my purpose for being part of the Coalition.

I understand my purpose for being part of the Coalition. Strongly Disagree

I understand my purpose for being part of the Coalition. Disagree

I understand my purpose for being part of the Coalition. Agree

I understand my purpose for being part of the Coalition. Strongly Agree

I understand my purpose for being part of the Coalition. Not Applicable

I am able to help the Coalition meet its work plan objectives.

I am able to help the Coalition meet its work plan objectives. Strongly Disagree

I am able to help the Coalition meet its work plan objectives. Disagree

I am able to help the Coalition meet its work plan objectives. Agree

I am able to help the Coalition meet its work plan objectives. Strongly Agree

I am able to help the Coalition meet its work plan objectives. Not Applicable

Question Title

* 3. How can we better involve you in the Coalition? (Select all that apply.)

I can join the Clinical workgroup

I can join the Childcare workgroup

I can join the School workgroup

I can join the Families/Community workgroup

I can help recruit new members to join the SMC Asthma Coalition

I can speak at City Council meetings on behalf of the SMC Asthma Coalition

I can represent the SMC Asthma Coalition at community events

Other (please describe)

San Mateo County Asthma Coalition Survey

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* 1. How are the planning and logistics of the Coalition?

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* 2. How well is the Coalition engaging you?

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* 3. How can we better involve you in the Coalition? (Select all that apply.)

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* 4. What else would you like to share with us?