This form is also available in Welsh.
We would like your help to improve our services, so please fill in this form to tell us about the service and support you have had from the Team Around the Family.  The information you put on this form will be kept strictly private and confidential and your name or other information will not show on any study report.

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* 1. Your Name

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* 2. Name of your Co-ordinator

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* 3. Did you know why you were getting help/support from Team Around the Family?

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* 4. Were you spoken to in your preferred language of choice?

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* 5. What difference has the help/support made to you and your family?

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* 6. Was the help/support you got from the Team Around the Family?

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* 7. Were you involved in the decisions made about you and your family?

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* 8. If not, why not?

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* 9. Did the Team Around the Family keep you updated about what was happening?

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* 10. Did the Team Around the Family do what they said they would do?

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* 11. If not, why not?

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* 12. Did you feel that your views and wishes were listened to?

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* 13. Please give examples of how your views, wishes have or how they have not been listened to and answered?

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* 14. Was there anything that was particularly good or particularly bad about the Team Around the Family?

Thank you for taking the time to fill in this survey.

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