Participant Feedback Form

PARTICIPANT FEEDBACK FORM
Important information before you begin.

1. Every section of this form must be opened and read, to ensure no information is missed.

2. Any section with questions that have a red star must be actioned in order to be able to move onto the next section.

3. Once you have completed each section you will be able to submit the form.
FEEDBACK IS ESSENTIAL

Your feedback is very important to us for making improvements to our services.

2. Rate Your Experience
RATE YOUR EXPERIENCE

Rate Your Satisfaction From 1 Heart Being Very Disappointed And 5 Hearts Being Very Happy.
Rate Our Reliability On Shifts, (Starting And Finishing Shifts On Time). *
Please provide more information
Based On Your Most Recent Experience, Rate Your Overall Satisfaction. *
Please provide more information
Rate Your Progress In Meeting Your Goals. *
Please provide more information
Please Rate Your Trust In Mighty Mentors*
Please provide more information
Rate Our Mentors And Their Ability In Supporting You*
Please provide more information
How Would You Rate Your Coordinator*
Please provide more information
How Would You Rate Our Systems And Procedures*
Please provide more information

3. Additional Feedback
ADDITIONAL FEEDBACK
Is there any training you feel your mentor(s) requires to enable them to support you better?*
Do you have a copy of your support plan?*

YesNo
Do you have a copy of your service agreement?*

YesNo
When was the last time your service coordinator did a check-in on your supports?*
Do you feel adequately supported by your coordinator and mentor(s)?*

YesNo
Would you be interested in our Group Camps or Respite services?*

YesNo
Please leave any other comments below.