* 1. How did you hear about Headwaters Family Visit Centre?

* 2. Staff provided a clear orientation to the program for both myself and my children.

* 3. I felt welcomed and was treated respectfully. I was listened to and felt understood.

* 4. Staff provided a safe and neutral setting for my child's visits and/or exchanges.

* 5. Staff were supportive and helpful before, during and after visits.

* 6. The service I received through Headwaters Family Visit Centre made a positive difference in my and/or my child's life.

* 7. Please rate your overall satisfaction with the service you received from Headwaters Family Visit Centre.

* 8. Do you have any suggestions that would help us to improve our service?

* 9. Please feel welcome to add any other comments you have about our service.

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