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Individual / Carer Feedback Form

1.  

The person completing this survey:

2.  

I have a say in decisions made about my care and treatment planning:

3.  

I am given enough time to say the things I want to say:

4.  

They understand the areas of life that are important to me and help me achieve this:

5.  

I am treated with kindness, as though I matter:

6.  

I am provided with advice and information about what is available to support me locally:

7.  

My worker has been professional, respectful and does what they say they will do:

8.  

The support I receive helps me to remain as independent as possible and feel safe:

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12.  

I would be interested in completing something like this again:

Maximum 255 characters

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Maximum 255 characters

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Maximum 255 characters

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