Feedback Form*Please help us to improve our service by giving honest rating of how satisfy you are with the care provided to you by our service using the below rating.1. Simeonbeth care staff are very punctual and dedicated to their job.*Disagreed Agreed Totally agreed Partially agreed 2. Staff are very compassionate and show empathy.*Agreed Totally agreed Partially agreed Disagreed3. Staff are very respective and protect my dignity.*Agreed Totally agreed Partially agreed Disagreed4. Staff are very patience and has listening ear.*Agreed Totally agreed Partially agreed Disagreed5. Staff always comply with standard procedures of infection control by using glove, washing hand, apron, when given care*Agreed Totally agreed Partially agreed Disagreed6. Staff always give me choices and promote my independence *Agreed Totally agreed Partially agreed DisagreedPlease rate SimeonBeth care service against the listed below care standards using the rating below*1-Very poor | 2- Poor | 3-Fair | 4 -Good | 5-Very good*7. Safe*123458. Responsive*123459.Effective*1234510. Caring*1234511. Well-Led*12345This portion addresses service user’s satisfaction*12. How satisfied are you with the care given to you?*Not satisfied Satisfied Very satisfied 13. How satisfied are you with the staff given care to you?*Not satisfied Satisfied Very satisfied 14. How likely would you recommend the service to another person *Not likely More likely Very likely Please tell us what you don’t like about the service or what you want us to improve on.*Name*FirstMiddleLastDate* *Form Fields Are Required! You have an error in your fields!
