We appreciate your opinion!
Thank you for taking the time to answer these questions. Please note you can submit your response at any time.
Would you like this feedback form to be anonymous?
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Yes
No
Do you currently use any our services?
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Yes
No
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Name
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First Name
Last Name
Email
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example@example.com
What age bracket are you in?
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Under 18
18 - 24
25 - 44
45 -64
65 and over
Gender
Please Select
Male
Female
Other
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What Anglicare North Coast services do you currently use?
Community Housing
Assistance with Food and Bills
Financial Counselling
Three Es to Freedom
Mental Health Support
I am a volunteer with Anglicare North Coast
I am a parish worker/volunteer
Other
Overall, how satisfied are you with your experience of Anglicare North Coast?
Very satisfied
Satisfied
Neither satisfied nor unsatisfied
Unsatisfied
Very unsatisfied
Do you agree with the following statements?
Does not apply
Disagree
Somewhat disagree
Somewhat agree
Agree
Anglicare listened to me
Anglicare was able to help me
Anglicare was respectful to me
In future, I would use Anglicare's services again
Which of the following best describes your situation before you were assisted by Anglicare?
I was not coping at all
I was managing but it was difficult
I was doing OK with some support
I was doing fine on my own
I was doing very well and able to help others
Which of the following best describes your situation now?
I am not coping at all
I am managing but it is difficult
I am doing OK with some support
I am doing fine on my own
I am doing very well and am able to help others
What particular aspect of our services do you like?
What particular aspect(s) of these services do you dislike?
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How did you hear/learn about Anglicare North Coast?
Please Select
Friend or Relative
Web search engine
Banner Ad
Magazine
E-mail
Referral from other service
Other
From your perspective, what could Anglicare North Coast work on or improve upon?
How likely would you be to recommend Anglicare North Coast to your friends or colleagues?
Never
1
2
3
4
Very Likely
5
1 is Never , 5 is Very Likely
Would you like us to contact you?
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Yes
No
Please enter your contact details below
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How often do you visit our website?
Please Select
Daily
Once a week
Once a month
Once a year
Never
Overall, how satisfied are you with our website?
1
2
3
4
5
How easy it to navigate our website?
Please Select
Very easy
Somewhat easy
Easy
Somewhat difficult
Very difficult
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