By completing this survey you will help us provide better services - Thank you!
  -  This survey is voluntary but will help us a lot.
  -  There are no right or wrong answers.
  -  The quality of the care and support you receive or the way you are treated will not be affected by your answers.

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* 1. CQRH/RHMS Practitioner's name (optional)

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* 2. What is your gender?

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* 3. How old are you?

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* 4. How many visits/ sessions have you had?

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* 5. How long have you been coming to CQRH/RHMS?

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* 6. Are you or Aboriginal or Torres Strait Islander Descent? 

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* 7. Please rate the following:

  Poor Fair Good Very Good Excellent N/A
Making an appointment
Booking transport (if required)
Reception (were the staff helpful and respectful?
Amount of time given for each visit/service/session
How helpful was your Support Worker/ Practitioner
How well did CQRH/RHMS staff encourage you to set goals and identify opportunities to meet those goals
How adequate were the room and facilities provided

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* 8. Please state your agreement with the following:

  Strongly Disagree Disagree Neutral Agree Strongly Agree
I was happy with the service I received.
The service was relevant to my needs.
I felt my Care/Support Provider listened carefully to me and understood my needs.
The quality of the servicies and support provided to my family/friends/carers/advocates by CQRH/RHMS was excellent.
I was involved in the decision making process with the CQRH/RHMS Care/Support Worker.
I would access CQRH/RHMS services again if I needed help in the future and was eligible to do so.

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* 9. Any other comments that might help us improve our service?

0 of 9 answered
 

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