GOCare Participant Exit Survey

GOCare Participant Exit Survey
This is a voluntary survey for participants who are leaving GOCare Support Services.

We would love to hear your feedback. Please answer the questions as fully as you can. You may be assisted by someone else to complete the survey. The questions all relate to your experience with GOCare.
Date*

DayMonthYear
Full Name*

First NameLast Name
What services did GOCare provide you?*

SIL HousingCommunity SupportSupported EmploymentRespiteGroup activitiesIndividual Support
How long were you supported by GOCare?*
What is your reason for leaving?*
Can you provide feedback in relation to your support by GOCare?
Would you like to provide other comments?
Please give us a ring 5500 1257 if you want to discuss your experience further.

We hope that you enjoyed your support with GOCare, and wish you all the best in the future.
Should be Empty: