Disability Action Haringey (DAH) Direct Payment Support Service: Customer Evaluation Survey

DISABILITY ACTION HARINGEY
Direct Payment Support Service: Customer Evaluation Survey
Name

First Name Last Name
Telephone

Home Mobile
Address
Email
example@example.com
1. Do you feel better informed and have increased choice, control, independence and well being as a result of DAH support? *

YES NO DON'T KNOW
Additional Comments:
Please type your comments about Support Services provided by DAH
2. Do you feel good quality and accessible information has been provided by DAH? *

YES NO DON'T KNOW
Additional Comments:
Please type your comments about Information Services provided by DAH
3. Do you understand the range of options available to you? That you can take all or part of a Direct Payment? *

YES NO DON'T KNOW
Additional Comments:
Please type your comments about your Range of Options provided by DAH
4. Do you feel you have increased confidence and will now need less support from DAH next time you recruit?

YES NO DON'T KNOW
Additional Comments:
Please type your comments about your Confidence Levels after talking with DAH
5. Do you understand how to gain a DBS check for employees and what the benefits of doing so are? *

YES NO DON'T KNOW
Additional Comments:
Please type your comments on how informed you now feel on DBS checks/benefits
6. Do you feel your experience of dealing with the DAH staff member was: *

Helpful Positive Effective Clear Negative Unhelpful Confusing
Additional Comments:
Please type your comments on how informed you now feel on DBS checks/benefits
Thank you for completing this feedback form, which will help to inform and improve future service delivery.
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DISABILITY ACTION HARINGEY

Direct Payment Support Service: Customer Evaluation Survey

Thank you for completing this feedback form, which will help to inform and improve future service delivery.