<p> Feedback</p><p>Now that you have run your ‘Spanner in the Works?’ program at your shed I hope that the event went well for you and that all the hard work and effort from all of you was worthwhile.</p><p>Before our memories lapse too much it is now time to put some thoughts down as to how it went at your shed. Please:</p><p> complete this feedback form and email as a MS Word document attachment – the Men’s Shed point of view. No PDF or JPEG please.  Send this information to the health staff who were there and ask them to complete and return by email. </p><p>A copy of each of the ‘Screening Results’ forms from the booklet are required. This can be done by:</p><p> Mailing the yellow copies of the Screening Results forms OR  Mailing a photocopy of the Screening Results forms  NB - Before sending please de identify each participants Screening Results form by either: o Blacking out ONLY the participants name and GP name on the yellow copy OR o Covering ONLY the participants name and GP name on the yellow copy and photocopying [AMSA will collate the information to gain an overall health snapshot of all those screened during the project. This information will be used by AMSA to highlight areas where future projects may be useful.]</p><p>Mail to: AMSA Po Box 793 The Junction NSW 2291</p><p>Feel free to add any information to the feedback form. Did you enhance the program by providing something extra or having guest speakers etc? Don’t be afraid to be critical as we need the negatives as well as the positives.</p><p>Feel free to contact me if you have any questions.</p><p>Gary Green</p><p>Community Engagement Coordinator Ph: 1300 550 009 Email: [email protected] </p><p>Feedback</p><p>1. Shed Name? </p><p>2. Health Service name and Health Worker name(s)? </p><p>3. Name of person completing this form? </p><p>4. State? </p><p>5. Screening date and times? </p><p>6. How many men turned up to the event (approximately)? </p><p>7. How many men underwent the screening process (approximately)? </p><p>8. If some men were not screened, why do you feel this is so? </p><p>9. Overall, what worked well and why? </p><p>10. Overall, what did not work well and why? </p><p>11. How can we make it better for next time? </p><p>12. Any other comments?</p>