Feedback Form

Date*

Role*

How would you rate, overall, the service that you have received?*

What did you like best about the service?*

Do you feel that there are ways in which the service could be improved?

YesNo

How could the service be improved? eg Frequency of Appointments, length of waiting times, location*

How would you rate ACE’s ability to keep you safe*

How would you rate the therapy you have received?*

What helped you most? eg coping strategies, mood diaries, talking/listening*

How would you rate the improvement in your emotional health whilst using the service?*

In what way has your emotional health improved? eg Anxiety levels, happiness, confidence*

How would you rate the effect the service has had on your life?*

In what way has this changed your life? eg School Attendance, changed family life, changed relationships, motivation*

Please tick if you consent to A.C.E sharing your comments anonymously for marketing purposes*

Yes

Any Other Comments