RAHC Health Professional Feedback Form Survey

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* 1. Placement Details
Your feedback is very important to us and will be used to further improve our services. Please answer the following questions

First Name

Last Name

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* 2. Health Service Name

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* 3. Clinic details

Community / Communities name

Reporting Manager name

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* 4. Please indicate your placement dates

Placement Start Date

Date

Placement End Date

Date

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* 5. Please select your Health Profession

Audiologist

Dentist

Dental Assistant

Dental Therapist

General Practitioner

Registered Nurse

Registered Midwife

Registered Nurse and Midwife

Remote Educator

Physiotherapist

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* 6. Is this your first placement?

Yes

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* 7. Overall, how would you rate your experience while on placement?

Excellent

Very good

Average / good

Poor

Very poor

Excellent

Very good

Average / good

Poor

Very poor

Comments

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* 8. To what extent do you agree or disagree with the following statements regarding your experience with RAHC?

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
The RAHC team responded to your queries in a professional and timely manner	The RAHC team responded to your queries in a professional and timely manner Strongly agree	The RAHC team responded to your queries in a professional and timely manner Agree	The RAHC team responded to your queries in a professional and timely manner Neutral	The RAHC team responded to your queries in a professional and timely manner Disagree	The RAHC team responded to your queries in a professional and timely manner Strongly disagree
You had appropriate access to cultural support and guidance while on placement	You had appropriate access to cultural support and guidance while on placement Strongly agree	You had appropriate access to cultural support and guidance while on placement Agree	You had appropriate access to cultural support and guidance while on placement Neutral	You had appropriate access to cultural support and guidance while on placement Disagree	You had appropriate access to cultural support and guidance while on placement Strongly disagree
You had appropriate access to clinical support and guidance while on placement	You had appropriate access to clinical support and guidance while on placement Strongly agree	You had appropriate access to clinical support and guidance while on placement Agree	You had appropriate access to clinical support and guidance while on placement Neutral	You had appropriate access to clinical support and guidance while on placement Disagree	You had appropriate access to clinical support and guidance while on placement Strongly disagree

Comments

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* 9. Did you feel safe/secure while on placement? – if not, please provide further details in comments

Yes

Comments

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* 10. Would you be interested in another placement with RAHC?

Yes

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* 11. Would you like to hear from RAHC regarding your responses today?

Yes

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* 12. Do you agree to RAHC using your feedback for marketing purposes?

Yes

If you are interested in another placement with RAHC please forward your dates of availability to your Workforce Officer or call the RAHC team on (08) 8942 1650

If you are experiencing any concerns or difficulties from your placement and you are not happy to discuss these with a RAHC Team member please contact the 24hours 7 day a week CRANAPlus Bush Support Service on 1800 805 391

Question Title

* 1. Placement DetailsYour feedback is very important to us and will be used to further improve our services. Please answer the following questions

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* 2. Health Service Name

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* 3. Clinic details

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* 4. Please indicate your placement dates

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* 5. Please select your Health Profession

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* 6. Is this your first placement?

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* 7. Overall, how would you rate your experience while on placement?

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* 8. To what extent do you agree or disagree with the following statements regarding your experience with RAHC?

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* 9. Did you feel safe/secure while on placement? – if not, please provide further details in comments

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* 10. Would you be interested in another placement with RAHC?

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* 11. Would you like to hear from RAHC regarding your responses today?

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* 12. Do you agree to RAHC using your feedback for marketing purposes?

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* 13. Finally, are there any other comments regarding your placement experience?

* 1. Placement Details
Your feedback is very important to us and will be used to further improve our services. Please answer the following questions