Client Feedback First Name Last Name Email Address Phone Number Do the services we offer meet your needs? * Yes No Somewhat If your needs are not being met, what areas do we need to improve? Quality of service delivery Meeting cultural needs Facilities/environment Community participation Overall management and operations Handling complaints/grievances Safety and well-being General enquires and information What do you think we can do to improve in these areas? Please list the specific area/s and your suggestions. Your suggestions, list here. How do you feel about the staff in our organisation? Tick one or more boxes. Very Competent Competent Not Competent Very friendly Friendly Not friendly In what areas could staff improve to meet your needs? Tick one or more boxes. * Job expertise/level of skills Cultural knowledge and skills Communication and listening skills Providing access to information Meeting individual needs Maintaining privacy and confidentiality Behaviour and attitudes Efficiency (things done on time) Providing feedback Working with other relevant agencies If an area is not listed above, please make suggestions here. What other improvements do you suggest for our organisation? If you would like to discuss any matters raised in this feedback form, please provide your name and contact number and/or email below.