Note: Participant can provide feedback at any time, however, this feedback will be collected on a quarterly basis.
Name (optional)
NDIS Number (Required)
Gender (Required)MaleFemaleOther's
Services Received (Required)
Email (Required)
Tick the option that best describes your response to each question. Leave the question if you don’t have any response.
1. Overall, I would rate the organisation as (Required) PoorFairGoodVery GoodExcellentDon’t Know
2. I am provided with clear communication about the services provided. (Required) PoorFairGoodVery GoodExcellentDon’t Know
3. I have a clear understanding of services provided by the staff / carer. (Required) PoorFairGoodVery GoodExcellentDon’t Know
4. I am respected and provided services in a dignified manner. (Required) PoorFairGoodVery GoodExcellentDon’t Know
5. I am asked to provide feedback on the services and staff / carer on a regular basis. (Required) PoorFairGoodVery GoodExcellentDon’t Know
6. I am happy with the level and reliability of support I receive from the organisation. (Required) PoorFairGoodVery GoodExcellentDon’t Know
7. How would text-dangeryou rate the management / governance of the organisation? YesNo
Please provide any specific feedback or suggestions for improvement. These can be related to the service being provided to you or anything related to the governance of the organisation.
