The Dual Diagnosis Service is interested in your input with regards to the different aspects of our service.The information provided is very important as it helps us to shape our services to better meet individual, family and community needs in the future.

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* 1. Family Name (if you choose):

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* 2. Please indicate your relationship with the individual:

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* 3. Please indicate the region the individual resides in: 

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* 4. Please indicate your level of satisfaction with the statements listed below.

With regards to intake:

The Dual Diagnosis Service intake process

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* 5. The Information provided in the brochures

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* 6. The time taken to start service

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* 7. With regards to the resource worker:

The availability and response time

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* 8. The support plan considered my opinions

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* 9. The overall service provided

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* 10. With regards to psychiatric services (If Applicable)

The recommendations were appropriate

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* 11. The recommendations considered my opinions

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* 12. The overall service provided

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* 13. With regards to nursing services (If Applicable)

The recommendations were appropriate

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* 14. The recommendations considered my opinions

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* 15. The overall service provided

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* 16. With regards to psychological services (If Applicable)

The recommendations were appropriate

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* 17. The recommendations considered my opinions

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* 18. The overall service provided

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* 19. With regards to behavioural services (If Applicable)

The recommendations were appropriate

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* 20. The recommendations considered my opinions

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* 21. The overall service provided

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* 22. With regards to speech and language services (If Applicable)

The recommendations were appropriate

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* 23. The recommendations considered my opinions

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* 24. The overall service provided

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* 25. With regards to occupational services (If Applicable)

The recommendations were appropriate

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* 26. The recommendations considered my opinions

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* 27. The overall service provided

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* 28. With regards to overall sevice

The improvement in quality of life

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* 29. With regards to overall sevice

The improvement in quality of life

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* 30. The improvement in knowledge and skills 

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* 31. The ongoing supervision of the support plan

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* 32. The individual - specific education and training

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* 33. The assessments

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* 34. The overall service provided

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* 35. Please complete the following by providing us with as much information as possible:

What was the most helpful part of the services provided by the Dual Diagnosis Service?

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* 36. What was the least helpful part of the services provided by the Dual Diagnosis Service?

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* 37. How can we improve the quality of the Dual Diagnosis Service?

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