Appointment and Service Feedback Form

Ace Centre appointment feedback form

Ace Centre appointment feedback form

Please tell us who you are: *
Please tell us what appointment you are giving feedback on: *
The Answers given should reflect those of the client's views of the service they received from Ace Centre.

Please state how much you agree with the following statements.

Scale Guide

  1. Strongly Disagree
  2. Disagree
  3. Neither agree nor disagree
  4. Agree
  5. Strongly Agree
The Answers given should reflect those of the client's views of the service they received from Ace Centre.

Please state how much you agree with the following statements.

Scale Guide

  1. Strongly Disagree
  2. Disagree
  3. Neither agree nor disagree
  4. Agree
  5. Strongly Agree
Please state how much you agree with the following statements.

Scale Guide

  1. Strongly Disagree
  2. Disagree
  3. Neither agree nor disagree
  4. Agree
  5. Strongly Agree
Please state how much you agree with the following statements.

Scale Guide

  1. Strongly Disagree
  2. Disagree
  3. Neither agree nor disagree
  4. Agree
  5. Strongly Agree
How did you join the appointment? *
How did you join the appointment? *
Where were you for the appointment? *
Where were you for the appointment? *
How did your SLT/ OT/ Teacher join the appointment? *
How did the client join the appointment? *
Where were they for the appointment? *
Where was the client for the appointment? *
Job title *
e.g. BD22 4BQ