1. AdvoCard Feedback Form

We are looking for your views on the service provided by AdvoCard. We would appreciate your time to tell us what you think.

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* 1. Who are you?

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* 2. Where did the advocacy take place?

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* 3. Was the advocacy provided by a volunteer, or a paid worker?

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* 4. Please rate the following statements about the advocacy provided:

  Strongly agree Agree Neutral Disagree Strongly disagree
The advocacy worker was capable and well-trained
I agreed with the course of action pursued by the service user and the advocacy worker
The advocacy worker helped the service user to speak for themselves
The advocacy worker was friendly
The advocacy worker was helpful
The advocacy worker did what the service user asked them to do
The advocate's involvement was beneficial
The advocacy worker helped the service user to be involved in decision making
The advocacy worker did what they said they would do
The advocacy worker helped the service user to have their voice heard

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* 5. If necessary, please explain why you have rated the above as you have.

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* 6. If appropriate, what difference did advocacy make?
Please list any outcomes achieved

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* 7. Is there anything that you would change about the advocacy?

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* 8. Will you recommend or refer to AdvoCard again in future?

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* 9. Please use this space for any other comments about AdvoCard that you may have

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* 10. If you would be willing to participate in a short telephone interview, please fill in your name and phone number here:

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