[comment memo="Participant Name"][text name="cXname" default=" "][checkbox name="compliance" value=" is compliant with the EXPLORE program.| is not compliant with the EXPLORE program."]
He attended [checkbox name="attendence" value="all sessions of the group|most sessions of the group|some sessions of the group|few sessions of the group| no sessions of the group"] for the month of [text name="RptMonth" default=" "]
He has completed [text name="PcntCmplt" default=" "] of the EXPLORE program.
[checkbox name="contributions" value="always helpful the group| rarely helpful to the group| sometimes helpful the group| a positive group member who was encouraging| a negative group member who was discouraging to the group procss| a leader within the group who helped everyone feel they had something to contribute| tried to involve others and asked for their input| sometimes asks for others input| always asks for others input| did not make the group work enjoyable| seemd to make the group work enjoyable"]
[checkbox name="participation" value="He actively participated in almost all of the sessions| He was withdrawn from the group| He constantly needed to be asked to be involved|He was an active participant about half of the time|He was an active participant most of the time"][checkbox name="wrkwithoth" value=" and usually let others contribute to group process| and usually worked with others to come to group conclusions| and completely dominated the discussions never letting others join in the thinking or doing process"]
He [checkbox name="attention" value="was always on task and kept others on task as well| rarely focused on the topic at hand| tried to get others off topic| sometimes was off topic but never hindered the groups performance| His contributions were helpful to the group learning process| His contributions were extremely valuable to the group learning process| His contributions did not help members learn the material"]
[checkbox name="listening" value="He listened to facilitators and other participants during presentations or discussions| He often did not listen to what was being said and done during presentations or discussions"]
[comment memo="Insight:"][textarea name="insight" default=" "]
[comment memo="Motivation:"][textarea name="motivation" default=" "]
[comment memo="Emotional expression:"][textarea name="emotionalexpression" default=" "]
[comment memo="Disclosed information about self:"][textarea name="personalInfo" default=" "]
[comment memo="FurtherViolence:"][textarea name="violence" default=" "]
[checkbox name="improvement" value=" Group objectives are being met| Participant seemed to benefit from the sessions"]
This program is not aware of any further intimate partner violence incidents or issues, nor has he reported anything of concern. Facilitators will continue to monitor his progress in the program.
Result - Copy and paste this output: