Valour Feedback Form

Valour Quality Support Survey

Please take a moment to fill out this survey
Name: Parent/ Guardian/ Carer/ School/ Teacher*

First NameLast Name
Email Address
example@example.com
Young Person (name or initials)*

First NameLast Name
Mentor/ Support Worker 1

First NameLast Name
Mentor/ Support Worker 2

First NameLast Name
Date*

DayMonthYear
Date
Do your Support Worker(s) give you feedback/updates about how the session went after the session?*

YesNoOther
Overall satisfaction of service
Do you have any complaints or concerns?*

YesNo
If you did have a complaint or concern, do you know who you would contact?*

YesNo
How would you rate our charity on a scale from 1 to 10 (1 being poor, 10 being excellent)? Anything below a 9 will have treat as a concern.*

10 out of 109 out of 10Other
How can we improve our service?*

Quality of service*

If we hosted for example a Fun Day during Bank Holidays, Easter Holidays, Summer Holidays or Christmas Holidays etc would your child be interested?*

YesNo
If you need to cancel or reschedule or cancel the session would you know who to contact?*

YesNo
Would you recommend our service?*

YesNo
Signature

Clear
MIGHTY MEN OF VALOUR
Mentoring |Training | Advocacy | Employment
PO Box 1417, Croydon, Surrey, CR9 0XJ
T: 0800 073 1325; M: 07958 770 779; F: 020 8240 7485; W: http://www.mightymenofvalour.org
Office hours: 0800 073 1325 10.30am to 3.30pm and Out of office hours: 07958 770 779.
Mighty Men of Valour a Company Registered in England No.05515628
CHARITY REGISTRATION NO: 1128154
Should be Empty:

Valour Quality Support Survey