SiT Feedback Form 2019

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* 1. Your name (Optional)

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* 2. Your postcode

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* 3. How did you hear about SiT?

Other (please specify)

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* 4. Which type of support did you receive?

Hold Fast Group

Hold Fast 1:1

Counselling / Therapy

Evolve

Phone / Online support

Other (please specify)

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* 5. Do you feel you have been ... (tick as many as apply)

Listened to

Believed

Respected

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* 6. Do you feel working with SiT has helped any of the following (tick all that apply)

Improved confidence / self esteem

Managing flashbacks, panic attacks better

Understanding the abuse wasn't my fault

Managing substance misuse better

Improved general wellbeing

Feeling less alone

Feeling less anxious

Feeling less depressed

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* 7. Do you feel more empowered since coming to SiT?

Yes

If yes, please describe how you have felt empowered

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* 8. I feel like I ....

Exceeded my main objective

Met my main objective

Didn't meet my main objective

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* 9. How would you rate the overall service you received at SiT?

Excellent

Good

Average

Poor

Very Poor

Can you tell us why you rated the service in this way?

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* 10. How would you rate the centre / facilities where you were seen?

Excellent

Good

Average

Poor

Very Poor

SiT Feedback Form 2019

Question Title

* 1. Your name (Optional)

Question Title

* 2. Your postcode

Question Title

* 3. How did you hear about SiT?

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* 4. Which type of support did you receive?

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* 5. Do you feel you have been ... (tick as many as apply)

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* 6. Do you feel working with SiT has helped any of the following (tick all that apply)

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* 7. Do you feel more empowered since coming to SiT?

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* 8. I feel like I ....

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* 9. How would you rate the overall service you received at SiT?

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* 10. How would you rate the centre / facilities where you were seen?

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* 11. Is there anything we can do to improve? Or any other feedback you would like to give

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* 12. Would you be interested in going our Service User Group. If so please provide your email address so we can make contact to discuss further.