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* 1. Person providing feedback:

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* 2. Name (optional):

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* 3. When thinking about your first experience of contacting and meeting Kern staff, please consider the extent to which you agree or disagree with the following statements: 

  Strongly disagree  Disagree  Neither agree nor disagree  Agree  Strongly agree 
My experience was positive
The staff were knowledgeable and helpful 
I felt confident that the services received would meet my expectations 
I felt heard and understood 
All my/my family member’s questions were answered 

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* 4. When thinking about your current Kern service, please consider the extent to which you agree or disagree with the following statements: 

  Strongly disagree  Disagree  Neither agree nor disagree  Agree  Strongly agree 
My Key Worker is knowledgeable and helpful 
My therapy team is knowledgeable and helpful 
I feel confident in my therapy team’s ability to help reach my goals and achieve positive outcomes 
I have choices about how and when therapy is delivered 
My/ my family member’s privacy and confidentiality is always respected 
Kern staff have provided me with relevant documentation to support me during my NDIS plan review process 

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* 5. I have received a copy of Kern’s Easy Read Feedback and Complaints Brochure: 

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* 6. I have received a copy of Kern’s Easy Read Guide to the Service Agreement 

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* 7. When thinking about your Kern service experience overall, please consider the extent to which you agree or disagree with the following statements: 

  Strongly disagree  Disagree  Neither agree nor disagree  Agree  Strongly agree 
I feel comfortable providing feedback about Kern or making a complaint 
I know how to provide feedback about Kern or make a complaint 
Overall, I am happy with the service Kern provides 
The service I have received from Kern so far has met my expectations 
I would recommend Kern therapy supports to others 

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* 8. If you disagreed or strongly disagreed with any of the above questions, what suggestions do you have for Kern to improve the quality of service delivery or our policies and procedures?

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* 9. Is there anything that Kern does particularly well that we should keep doing?

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* 10. If you self manage your funding, or have a Plan Manager, do you have any feedback on Kern’s system of invoicing? (Leave blank if not applicable)

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* 11. Are there any other therapy related services and supports you would like Kern to offer? 

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* 12. Are there any policies and/or procedures you would like a copy of, or would like to provide feedback on? 

0 of 12 answered
 

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