Client Satisfaction Survey
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.
1.
CQRH/RHMS Practitioner's name (optio
nal)
2.
What is your gender?
Female
Male
Other (please specify)
3.
How old are you?
Under 25
25 - 59
60+
4.
How many visits/ sessions have you had?
Once only
More than once
5.
How long have you been coming to CQRH/RHMS?
A year or less
More than two years
6.
Are you or Aboriginal or Torres Strait Islander Descent?
Yes, Aboriginal
Yes, Torres Strait Islander
No
7.
Please rate the following:
Poor
Fair
Good
Very Good
Excellent
N/A
Making an appointment
Poor
Fair
Good
Very Good
Excellent
N/A
Booking transport (if required)
Poor
Fair
Good
Very Good
Excellent
N/A
Reception (were the staff helpful and respectful?
Poor
Fair
Good
Very Good
Excellent
N/A
Amount of time given for each visit/service/session
Poor
Fair
Good
Very Good
Excellent
N/A
How helpful was your Support Worker/ Practitioner
Poor
Fair
Good
Very Good
Excellent
N/A
How well did CQRH/RHMS staff encourage you to set goals and identify opportunities to meet those goals
Poor
Fair
Good
Very Good
Excellent
N/A
How adequate were the room and facilities provided
Poor
Fair
Good
Very Good
Excellent
N/A
8.
Please state your agreement with the following:
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I was happy with the service I received.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The service was relevant to my needs.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I felt my Care/Support Provider listened carefully to me and understood my needs.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The quality of the servicies and support provided to my family/friends/carers/advocates by CQRH/RHMS was excellent.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I was involved in the decision making process with the CQRH/RHMS Care/Support Worker.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I would access CQRH/RHMS services again if I needed help in the future and was eligible to do so.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
9.
Any other comments that might help us improve our service?
Current Progress,
0 of 9 answered