Feedback Form - Base - Relationships WA

If Other, please give details

My Case Manager/Counsellor/Records Officer created a safe place for me to explore my issues

Members of the family are safer

If you are ending your counselling, what would your reason be?

Problem sufficiently resolved
Not making sufficient progress
Unhappy with the service
Taking too long to sort out

I felt comfortable to contact my Case Manager/Counsellor when I needed support

Name

Today's date

Age

Gender

Course name

Location

Facilitator

Any other comments?

Are you interested in attending more programs, specifically for fathers?

As a result of working with 4families, I feel more able to support and assist my child to build on their strengths

As a result of what I learned in the child focus session I am more aware of how behaviour attitude affects my children

Comments on the style of facilitation

Communication is better with the other party

Did any of the following features of the services help you?

Did the service listen and understand your worries?

No
Not Sure
Yes

Did you feel safe at the centre?

No
Not Sure
Yes

Do you feel you received some benefit simply from coming to the course?

Did you follow up referral?

Did you make another appointment?

If No, what were the reasons (please select)

If Yes, do you have any comments to make on the value of the referral?

Do you have any further comments?

Do you have one suggestion to improve the training for next time?

Do you have suggessions for improving any aspects of our service, if so please tick one or more boxes given and give details?

Do you have any other suggestions or comments regarding the session you have just attended?

Do you think working with 4families has helped you with your worries

Do you think coming has helped with your worries?

No
Not Sure
Yes

Has coming to the child contact centre helped you?

No
Not Sure
Yes

Have you accessed new or additional government benefits or support because of the money you lost?

Have you lost any money and/or assets as a result of the issues you have experienced?

How did I receive support?

How did it make you feel working with 4families?

Not very happy
Not sure
Very happy

How did you find the delivery method?

How has working with 4families helped you?

I am better able to deal with issues that I sought help with*

I am better able to access services now to support me in achieving my goals

I am better able to deal with social, emotional and psychological trauma that resulted from sexual assault/abuse

I am better informed about the Family Dispute Resolution process and the options available to me

I am more confident to make decisions based on my needs*

I am now more aware that there are services and supports that can help me*

Any other comments?

I am satisfied with how my issues have been resolved*

Any other comments?

I am satisfied with the services I have received

I am satisfied with the options provided to resolve my issues

Any other comments?

I am satisfied with the way the group was run*

I am using the services I have been referred to for my issues*

Any other comments?

Identify at least one way that this training will impact on your work*

I feel better for speaking to someone about my worries*

I feel supported to deal with my situation*

Any other comments?

I felt comfortable to contact my Case Manager/Counsellor/Records Officer when I needed support *

I feel that the 4families program was just the right length of time to help me*

I felt listened to and understood*

I felt supported and helped to work out my worries*

I gained a better understanding of the importance of a co-operative parenting alliance*

I have increased awareness/knowledge on sexual abuse & how to stay safe*

I have been referred to services that can help me*

Any other comments?

I have increased knowledge and awareness of services *

I feel better able to deal with my issues*

If other add additional comments

Any other comments?

I feel like I could take legal action if I choose*

Any other comments?

I feel like I have what I need to deal with my issues*

Any other comments?

I felt supported when I contacted your service*

If so, what new strategies/skills have you used?*

If you are ending your counselling, what would your reason be? (please tick one or more items)

If you were referred to our services from the Family Relationship Centre, where were you referred?*

I got the help I wanted to address my issues*

I have gained knowledge of how to cope or deal with my situation*

I know what to do if I feel this way again in the future

I now have improved strategies for self care*

In what way was it helpful?*

Property/Assets*

Finances*

Financial support for children*

Parenting arrangements*

Other

I received an adequate explanation of confidentiality of service*

Is there anything else you would like to tell us about your experience with Relationships Australia?

Is there anything you didn't like about coming?

Is there anything the service could have done better?

I trust and respect services that can help me deal with my situation*

Any other comments?

I was able to access this service in a timely manner*

I was clear about expectations practitioners and I were working towards*

I was treated with respect*

I was treated with respect during the Family Dispute Resolution process*

I would come back to 4families again if I needed to*

I would recommend this course to others in a similar situation to me*

I would recommend this service to others

Making an appointment at Relationships Australia went smoothly*

Mediation room was satisfactory*

My Case Manager/Counsellor and I worked well together*

My Case Manager/Counsellor created a safe place for me to explore my issues*

My Case Manager/Counsellor/Records Officer and I worked well together*

My counsellor created a safe place for me to explore my issues

My counsellor and I worked well together

My family can function independently and participate in activities*

My relationship with other family members has improved*

My relationship with the child/ren has improved*

Overall, how satisfied are you with the outcomes of the service you received from Relationships Australia

Overall, how satisfied are you with the way the group was run*

Please add any comments that you think would help improve our service

Do you have any suggestions or comments on improving our service?

Please indicate if you are the following

Please let us know if there was anything that you liked or didn't like about our service, or something you feel we could do better

Relationships with child/ren have improved*

Suggestions you feel will improve our service

The administration staff members were efficient and respectful

The Child Contact Service met my needs*

The child/ren experience less conflict*

The child/ren's wellbeing has improved*

The Child Focus Session helped me better understand my child/ren's experience of our separation*

The Child Focus Session helped me understand how children experience conflict*

The content was clear*

The counsellor s approach fitted well with me

The counsellor listened to me and seemed to really understand me

The different ideas were useful*

The facilitator had good knowledge of the topic*

The information was relevant to my work*

The method of training was helpful*

The parenting arrangements are workable*

The practitioner/s were focused on the needs, safety and wellbeing of the child/ren throughout the process*

The practitioner understood my situation*

The program helped me to identify and set goals to work towards*

The program provided me with the opportunities to be linked to other local services*

There is better communication between parents*

The service met my needs

Think about the first time you came to Redress, and how you were feeling at the time. Please tick the option that best describes how you feel now*

This session helped me to understand how children of different ages respond differently to their parent's separation*

The service listened to me and understood my issues

The service was helpful in assisting me in relation to providing support to my family*

There is less conflict in the family*

Think about the first time you came to Lanterns, and how you were feeling at the time. Please tick the option that best describes how you feel now

To what extent would you recommend this course to others in a similar situation to yourself*

Was the session helpful?*

Were the workers friendly to you?

No
Not Sure
Yes

Were you provided with any referrrals?*

What feedback would you like to give the facilitator(s)?

What did you find most helpful?

What did you find most helpful/least helpful about the service?

What did you find most useful for you personally?

What did you like most about working with 4families?

What did you like the least about working with 4families?

What did you like most about coming?

What ideas or topics were of most value to you in your work?

What is the total value of money and and/or assets you have lost (estimate)?*

What options did you pursue?

What options were you given to resolve your issues?

What time is suitable

Morning
Afternoon
Early Evening
Weekends

What topics would you like to be presented

What were the reasons for ending the Family Dispute Resolution (please tick one or more items)*

If Other, please give details

Any other comments?

What were the reasons for ending the service (please tick one or more items)*

Problem sufficiently resolved
Child did not want to continue
Taking too long to sort out
Not making sufficient progress
Unhappy with the service
Practical issues such as time, distance, relocation etc

What we talked about/did was helpful for me

What would improve the session?

Why did you/did you not pursue these options?

Why do you think these features did/did not help you?

Why do you think they were/were not the right services for your issues?

Would you like to come back to 4families again if you had worries again?

I would not be happy to come back
Not Sure
I would be happy to come back

Would you like to join our mailing list to receive our course timetable each term?*

At this moment in time, how would you rate the quality of your relationship with your family?*

At this moment in time, how would you rate your mental health, wellbeing and self-care?*

Now that you've attended the course, what is the process of your knowledge and information relating to the topic?*

Now that you've attended the course, how do you think the quality of your relationships with your family will be in the future?*

Now that you've attended the course, how do you think your mental health, wellbeing and self-care will be in the future?*

The facilitator was respectful and inclusive of all participants*

Why are you here today?

Communication is an issue with the other party*

There is conflict between myself and the other party*

I have a good relationship with the child/ren*

The current situation is impacting on the child/ren’s wellbeing*

I have been involved in making decisions about the child/ren's care arrangements since separation*

Do you have any suggestions or comments about your contact and communication with the Family Relationship Centre?