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. Where did you use advocacy?

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

  Strongly agree Agree Neutral Disagree Strongly disagree
The advocacy worker was capable and well trained
The advocacy worker helped me to be involved in decision making
The advocacy worker helped me to have my voice heard
The advocacy worker did what I asked them to do
The advocacy worker was friendly
The advocacy worker helped me to speak for myself
The advocacy worker was helpful
The advocacy worker did what they said they would do

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

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

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

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* 6. Will you use AdvoCard again in future?

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

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

Thanks for your time in completing this survey.

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