Service Experience Feedback Company We welcome feedback from all sources to help improve, grow and make positive changes to our services. Please be as open and honest as you can as we believe transparency and candour is the best way to build effective relationships. Are you A User Member A Family Member A Health/Care Professional A CCCV Team Member Other please check all that apply Please tell us about your experience with Cooperative Care Colne Valley Has the service made a positive impact? Yes No Don't know Optional additional comments Have you experienced any challenges or issues when working with Cooperative Care Colne Valley? Yes No Do you believe the service to be safe? Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Please provide any additional information to help explain your answer Do you believe the service to be effective? Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Please provide any additional information to help explain your answer Do you believe the service to be caring? Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Please provide any additional information to help explain your answer Do you believe the service to be responsive? Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Please provide any additional information to help explain your answer Do you believe the service to be well led? Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Please provide any additional information to help explain your answer Are there any other comments that you would like to make? If you would like us to respond directly to any of the points you have made in your feedback please provide your name and contact information below. Otherwise you can simply ignore the rest of this form and submit anonymous feedback. Your name A phone number where we can reach you And/or an email address
