Client Feedback Sheet

Date	____/____/____

Thank you for taking the time to complete this feedback sheet. We will use your comments to improve our services. This is a confidential document and names are not required.

Please tick the relevant box to record your answers to the following questions:

Do the services we offer meet your needs?
 Yes	 No	 Some      

If your needs are not being met, what areas do we need to improve?
 Quality of service delivery	 Overall management and operations	
 Meeting cultural needs	 Handling complaints/grievances	
 Facilities/environment   	 Safety and well-being	
 Community participation	 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.
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How do you feel about the staff in our organisation? Tick one or more boxes.
 Competent 	 Very Competent 	 Not Competent
 Very friendly 	 Friendly	 Not friendly

In what areas could staff improve to meet your needs? 

 Job expertise/level of skills 	
 Cultural knowledge and skills
 Communication and listening skills
•	Providing access to information
•	 Meet 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, use the space below for other suggestions.
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What other improvements do you suggest for our organisation?
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If you would like to discuss any matters raised in the feedback sheet, please provide your name and contact number in the space below.

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Thank you for your comments.