compliments, complaints, suggestions
headspace Ballarat welcomes and appreciates your feedback. It helps us identify what we are currently doing well and where we could improve to provide a better experience for young people, their family and friends.
I would like to provide a...
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compliment
complaint
suggestion
I am providing feedback as a...
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young person who has accessed headspace Ballarat services
family member or friend of a young person who has accessed headspace Ballarat services
family member or friend who has directly accessed parent/carer supports at headspace Ballarat
professional who has referred a young person to headspace Ballarat or is working with a young person engaged with headspace Ballarat services
other
Your name
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First Name
Last Name
Your organisation
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Your position/role
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My feedback relates to the following service(s):
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intake and engagement team
drop in service
my regular mental health clinician
other health services including GP, dietitian, AOD and sexual health teams
youth employment program (YEP team)
peer work team
reception and administration team
centre management
a group program
other
Name of service provider or program
Date of service
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Day
-
Month
Year
If service is ongoing, please select the date of your most recent experience
Please tell us about your experience with headspace Ballarat:
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Please share your ideas or suggestions with us:
Would you recommend headspace Ballarat to your friends?
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Yes
No
Maybe
Would you return to see us again in the future?
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Yes
No
Maybe
Would you like us to contact you about your feedback?
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Yes
No
I would like remain anonymous
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Yes
No
Contact details
Name
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First Name
Last Name
Date of birth
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Day
-
Month
Year
Date
Preferred contact method
phone call
email
Email address
Phone number
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