Putson Service Providers Survey

1. Service Providers Survey

We have been commissioned by Putson Community Association to undertake some consultation in relation to the development of new community facilities in Putson, including the new estate. As part of the consultation process we are keen to engage service providers to find out whether they may be interested in delivering their services from any new facility. We would be grateful if you could find the time to complete this survey and return it by Friday 13th August. Thank you

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* 1. Please provide your contact details

Name

Organisation

Telephone

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* 2. Do you currently deliver outreach services in the South Wye area? If yes, please provide details below. If no, got to question 5.

Yes

When and where do you deliver your outreach services

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* 3. Do the current facilities you use meet your needs? If not, please specify why below

Yes

Why do the current facilities you use not meet your needs?

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* 4. How much do you currently pay to use this facility? Please give an hourly rate

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* 5. Are you aware of a demand for your services in the Putson area? If yes, please state what evidence you have to support this.

Yes

Please provide details of the evidence of demand for your service

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* 6. Are you considering delivering your services on an outreach basis in the South Wye area in the future?

Yes

Possibly

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* 7. Have you identified additional outreach services, which you would like to deliver in South Wye? If yes, please specify

Yes

Please provide details of outreach services you would like to deliver

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* 8. Are you facing any barriers to delivering additional outreach services in South Wye? If yes, please specify below

Yes

Please specify the barriers you are facing

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* 9. Would you be interested in delivering services from any new community facility in Putson?

Yes on a daily basis

Yes on a weekly basis

Yes on a monthly basis

Yes on an occasional basis

Possibly

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* 10. Would you be interested in relocating or establishing a new office base in the new community facility in Putson? If no, go to question 14

Yes

Possibly

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* 11. Which of the following facilities would you require to deliver your outreach services?

	Essential	Desirable	Not needed
Separate Entrance	Separate Entrance Essential	Separate Entrance Desirable	Separate Entrance Not needed
Kitchen	Kitchen Essential	Kitchen Desirable	Kitchen Not needed
Parking	Parking Essential	Parking Desirable	Parking Not needed
Break-out rooms	Break-out rooms Essential	Break-out rooms Desirable	Break-out rooms Not needed
Reception facilities	Reception facilities Essential	Reception facilities Desirable	Reception facilities Not needed
Storage facilities	Storage facilities Essential	Storage facilities Desirable	Storage facilities Not needed
Office facilities	Office facilities Essential	Office facilities Desirable	Office facilities Not needed
Hall / Conference room	Hall / Conference room Essential	Hall / Conference room Desirable	Hall / Conference room Not needed
Soundproof Counselling / Interview room	Soundproof Counselling / Interview room Essential	Soundproof Counselling / Interview room Desirable	Soundproof Counselling / Interview room Not needed

Other (please specify)

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* 12. Which of the following amenities / equipment would you require to deliver your services?

	Essential	Desirable	Not needed
Panic buttons	Panic buttons Essential	Panic buttons Desirable	Panic buttons Not needed
Telephone point	Telephone point Essential	Telephone point Desirable	Telephone point Not needed
Broadband	Broadband Essential	Broadband Desirable	Broadband Not needed
Access to photocopier	Access to photocopier Essential	Access to photocopier Desirable	Access to photocopier Not needed
Projector & screen	Projector & screen Essential	Projector & screen Desirable	Projector & screen Not needed
TV	TV Essential	TV Desirable	TV Not needed

Other (please specify)

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* 13. How much would you be prepared to pay for the hire of the facilities you would require? Please give an hourly rate

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* 14. Any other comments?

Thank you for taking the time to complete this survey your input is very much appreciated. If you would like to discuss the development of new community facilities in Putson in more detail please do not hesitate to contact Claire or Sarah on 01432 860 323.