Milieu Evaluation Form
Please rate the following aspects of the milieu. Your honest feedback helps us improve the environment and overall experience.
Overall cleanliness of the environment
*
1
2
3
4
5
Sense of safety in the environment
*
Very Unsafe
1
2
3
4
Very Safe
5
1 is Very Unsafe, 5 is Very Safe
Comfort of the physical space
*
1
2
3
4
5
Organization and tidiness of the setting
*
Very Disorganized
1
2
3
4
Very Organized
5
1 is Very Disorganized, 5 is Very Organized
Availability and accessibility of resources
*
Not Available
1
2
3
4
Always Available
5
1 is Not Available, 5 is Always Available
Level of support provided by staff or facilitators
*
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
Opportunities for engagement and participation
*
None
1
2
3
4
Abundant
5
1 is None, 5 is Abundant
Social climate (e.g., sense of community, respect among participants)
*
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
Please rate your overall satisfaction with the milieu
*
1
2
3
4
5
Additional comments or suggestions
Submit Evaluation
Should be Empty: