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FEEDBACK FORM


  1. Your Name or Alias:

  2. The Date you contacted MYH:

  3. Would you like to be contacted by MYH:

  4. If so, please provide your email:

  5. Are you satisfied with the way our helpline has supported you?


  6. Please Explain which contact methods you are satisfied/dissatisfied with and why?


  7. Please Explain what elements of the MYH you are satisfied/dissatisfied with and why?
  8. Comments/Explanation:



  9. Has the helpline identified the help you need and met your needs in an appropriate way?
  10. Comments/Explanation:

  11. Do you feel that the helpline worker was empathetic to your needs?
  12. Comments/Explanation:

  13. Do you feel that the helpline worker has listened to your views and took them into account?
  14. Comments/Explanation:

  15. Do you feel that that the options explored were relevant to your situation?
  16. Comments/Explanation:

  17. Have the services provided by MYH made a difference in your life?
  18. Comments/Explanation:

  19. Would you use the service again?
  20. Comments/Explanation:



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