Feedback Form

We want to provide you with a positive experience when accessing our services. Please let us know if we are achieving this or if you think we can improve.

Date: * +

Which service or services does your feedback relate to? (You can select more than one). *

	Yes	No	Neither	N/A
Did you feel welcome when accessing our services online or in person?	Yes	No	Neither	N/A
Did we treat you warmly and politely?	Yes	No	Neither	N/A
Did your Adviser/Counsellor see you on time?	Yes	No	Neither	N/A
If you've requested an interpreter, was it provided to you?	Yes	No	Neither	N/A
Did you have enough time to discuss your issues with your Adviser/Counsellor?	Yes	No	Neither	N/A
Did your Adviser/Counsellor ask you if you have other issues you would like to discuss with them?	Yes	No	Neither	N/A
Did the Adviser/Counsellor discuss other services you may be able to access withing LRMN or other organisations?	Yes	No	Neither	N/A
Are you satisfied with the service you have just received from us?	Yes	No	Neither	N/A

How did you hear about us?

Are there any other comments/feedback you would like to share to help us improve our services?

Are you happy for us to use your feedback in our publicity?

Yes

No