Talk Well Feedback Form

Question Title

* 1. Which service did you (or your child) receive from Talk Well

Counselling

Talk Well Chat (anonymous helpline)

Parent Support and Advice line

Parent Support Group

Receptionist

Question Title

* 2. How likely is it that you would recommend Talk Well to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

0

1

2

3

4

5

6

7

8

9

10

0

1

2

3

4

5

6

7

8

9

10

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* 3. Overall, how satisfied or dissatisfied are you with Talk Well?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

Question Title

* 4. Did the support from Talk Well help you with your difficulties? (or your child's difficulties)

Yes totally

Yes a lot

Yes a medium amount

A little

Not at all

Question Title

* 5. Do you have any other comments, questions, or concerns?

Question Title

* 6. Please enter your name (this is optional - leave blank if you prefer)

Question Title

* 7. Thank you for using this form. We welcome all feedback, it helps us to know what we're doing well and how we can improve. Please leave your name and contact details if you want us to know who you are or want a reply. If you wish to receive a reply to your feedback please leave your contact information e.g. an email address or a phone number