Please tick the relevant box to record your answers to the following questions:

I am a
ParticipantFamily MemberParticipant RepresentativeStaff MemberStaff member on behalf of a participantOther

Name

Anonymous
Anonymous

Tell us which service you are providing feedback about? Tick one or more boxes.
Support WorkSupport Co-ordinationBehaviour Support(Improved Relationships)Psychology (Improved Daily Living)

Tell us how satisfied you are with this service?
Very DissatisfiedDissatisfiedNeutralSatisfiedVery Satisfied

Tell us what we did well? Tick one or more boxes.
Quality of service deliveryMeeting cultural needsFacilities/environmentCommunity participationOverall management and operationsHandling complaints/grievancesSafety and well-beingGeneral enquires and information

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Tell us where we could improve? Tick one or more boxes.
Quality of service deliveryMeeting cultural needsFacilities/environmentCommunity participationOverall management and operationsHandling complaints/grievancesSafety and well-beingGeneral enquires and information

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Tell us how you feel about the staff at Journey Health Solutions? Tick one or more boxes.
CompetentVery CompetentNot CompetentVery friendlyFriendlyNot friendly

In what areas could staff improve to meet your needs? Tick one or more boxes.
Job expertise/level of skillsCultural knowledge and skillsCommunication and listening skillsProviding access to informationMeet individual needsMaintaining privacy and confidentialityBehaviour and attitudesEfficiency (things done on time)Providing feedbackWorking with other relevant agenciesOther

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If you would like to discuss any matters raised in the feedback sheet, please
provide your name and contact number in the space below.