Participant Feedback Form

This is a confidential anonymous survey for participants of the Southern NSW Partners in Recovery (PIR) Program. By completing this form you will assist us to evaluate and improve the program. Please write any additional comments in the section at the end.


 
Tell us how strongly you AGREE or DISAGREE with each of the following statements and questions?


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* 1. I have benefitted from participating in PIR.

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* 2. I received appropriate information when joining the PIR program.
For example; my Rights and Responsibilities were explained and I was provided information about PIR and the role of my Support Facilitator.

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* 3. My individuality and values were respected.
For example; culture, faith or gender identity.

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* 4. My Support Facilitator helped me feel hopeful for my future.

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* 5. My Support Facilitator assisted me to access services that improved my quality of life.
For example; things are better for me as I go about my day.

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* 6. My Support Facilitator was punctual, professional and reliable.

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* 7. My Recovery Action Plan considered all my needs.
For example; my living situation, health problems, employment and social connections.

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* 8. My personal recovery goals and lived experience were respected by my Support Facilitator.

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* 9. The people important in my recovery journey were included in the development of my Recovery Plan.
For example; carer, GP, service providers.

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* 10. I feel better equipped to manage my recovery journey since being in PIR.

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* 11. Can you tell me a few words that help summarise your time in PIR?

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* 12. If your experience in PIR has been less than what you had hoped or expected please tell us why.

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* 13. Do you have any other comments about the PIR Program?

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* 14. About you - what gender are you?

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* 15. What age group do you belong?

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* 16. In which Partners in Recovery Region do you live?

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* 17. (Optional) What is the name of your Support Facilitator?

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