* 1. Date

Date

* 2. Initials

Please respond to as many questions as you wish. The service values your contribution and thanks you for your support in our commitment to improving our service delivery. Please circle your choice

* 3. How safe have you felt today while you are at court?

* 4. Do you feel that you have had sufficient privacy with the Court Support Worker/s in talking about your personal issues?

* 5. How useful was the support provided in responding to your needs?

* 6. How comfortable did you feel in talking to the Court Support Worker/s about your court issues?

* 7. Were you aware that there would be support for you at court today before attending?

* 8. Were the out front workers helpful in assisting you to check into court today?

* 9. Do you have any further comments or information that you think would be useful for DVAC to know about?

Thank you

T