KO-NEKT Contact Form

Your Details:
Full Name:

First NameLast Name
Email:
example@example.com
Phone Number:
Please enter a valid phone number.Format: 00 000 000000.
Organisation (if applicable):
Getting in Touch:
Preferred method of contact (select all that apply):
Best time to contact: (Select one or more)
About Your Enquiry:
Which best describes you?

Other
Who or what is the enquiry about?

Other
Where do you live or work?

Other
Feedback
We want to hear from you!

At KO-NEKT, we welcome all feedback — whether it’s a compliment, a comment, or a complaint. Your views help us improve our services, celebrate successes, and address any serious issues.

Please use this form to share your experience or raise a concern. Your information will be handled confidentially and fairly.
Your Feedback Type:
For a formal complaint, please include:

• What happened
• Date(s) and time(s) of the incident(s)
• Names of those involved (if applicable)
• Your desired resolution (if any)

We will confirm receipt within 5 working days and aim to respond within 15 working days.
Please tell us about the service, staff member, or experience you want to recognise. Include as much detail as possible so we can pass on your thanks and celebrate good work.
Please share your ideas, suggestions, or feedback. We regularly review comments to help improve our services, and we may be able to update you if your suggestion is implemented.
Please describe your complaint.
Tell us what happened, when it happened, and who was involved (if applicable). Include your desired resolution, if any. The more detail you provide, the easier it will be for us to investigate.
Please describe your compliment.
Tell us who or what you are recognising, and describe what was done well. Include any details that will help us pass on your thanks.
Please describe your comment or suggestion.
Share your ideas or feedback on our services or operations. Include any details that would help us understand and consider your suggestion.
Supporting Evidence

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What Can We Help You With?
What are you interested in? (Select all that apply)
Name of Child or Young Person:
Child or Young Person's Date of Birth:

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Address:

House Number and Street

Town

Post Code
How can we help?
Diagnosis (short description):
Indicative Budget:
Approximate Time Requirements:
Mornings, Afternoons, Evenings, Weekends, Holiday Cover etc
Requirements:
121 Community, 221 Community, 121 in Group, Group Support General (Please note group support only available in Ayrshire)
How Did You Hear About Us?
How did you hear about us?

Other
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Signature
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Your Details:

Getting in Touch:

About Your Enquiry:

Feedback

What Can We Help You With?

How Did You Hear About Us?

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