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Client Exit Comments Survey
1.
Client Name (optional):
2.
Service (optional):
3.
Date:
4.
Length of stay in service:
5.
How well-supported by staff were you in achieving your goals/ recovery?
6.
Tell us what experiences you enjoyed during your time with Pact:
7.
Tell us about any problems you had during your time with Pact:
8.
Please give us any suggestions for improvement:
9.
How do you rate the support you received?
Excellent
Above Average
Average
Below Average
Poor
Comments:
10.
For people who stayed in supported accommodation, please answer:
How do you rate the food and meals?
Excellent
Above average
Average
Below average
Poor
Not Applicable
Comments:
11.
For people who stayed in supported accommodation, please answer:
What do you think of your room?
Excellent
Above average
Average
Below Average
Poor
Not Applicable
Comments:
12.
Did you feel the length of time you spent with Pact was appropriate?
Thank you for filling in this form - we appreciate your feedback. Information you give here will be shared with Pact staff so Pact is able to continually make improvements to its services.
