This form has been developed for staff and volunteers from the Healthwatch organisations across West Yorkshire and Harrogate to capture feedback on Stroke Services when a survey would not be an appropriate method to use, for example during discussion groups, attending a meeting etc.

Please provide a brief summary of the engagement activity that took place and the comments made.

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* 1. Which Healthwatch organisation are you from?

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* 2. When did the engagement take place?

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* 3. Where did the engagement take place?

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* 4. What method of engagement did you use?

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* 5. How many people did you engage with?

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* 6. Please use this space to add any additional information about the engagement activity.

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