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We Asked, You Said, We Did
6 Week Review Questionnaire 2018 - 2019
Page 1 of 3
Closes
29 Mar 2019
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Introduction
Please enter the following details
Date Completed
Please enter the date survey completed
Were you given a leaflet about the service?
Yes
No
Comments
Were you offered an informal visit?
Yes
No
Comments
Were you given enough information about the service? Is there anything else you would like to know?
Yes
No
Comments
Was the Key Worker role explained to you?
Yes
No
Comments
Was risk assessment discussed with you?
Yes
No
Comments
Was medication discussed with you?
Yes
No
Comments
Was your personal plan discussed and agreed with you?
Yes
No
Comments
How does your personal plan meet your needs?
Comments
How were you involved in the planning of this review?
Comments
How did you feel about the meeting?
Comments
Is there anything that could have been better during this process?
Comments
How do you rate your overall experience?
Excellent
Very Good
Good
Adequate
Weak
Unsatisfactory
If you wish to make any other comments please include in the space below.
If you wish to make any other comments please include in the space below.
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