A short survey providing valuable feed back for us. Thank you for your cooperation.

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* 1. What was the date of your appointment?

Date

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* 2. I felt heard by the counsellor today.

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* 3. I felt the Family Healing Service respected my confidentiality.

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* 4. I felt the amount of support I received today helped

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* 5. I feel that home visits are...

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* 6. Other comments you would like to make regarding the support you received today

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* 7. On a scale of 1 - 10, how would you rate your overall satisfaction with the care you received today? (10 stars the best, 1 star poor)

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* 8. What changes would you like to see in the way we offer our care and programs at Gurriny Yealamucka?

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* 9. Would you like to discuss this more with us?

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* 10. To enable us to discuss this with you, can we have your best contact details?

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