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Wellbeing at Swinburne

Client Feedback Form

Wellbeing at Swinburne strives to serve you better and we are committed to continually improving our patient/ client service standards. In order to help us improve our service, we invite you to let us know what you think using the following form.

Fields marked with an * are mandatory.

How did you engage with Wellbeing at Swinburne?*

How did we provide the service to you?*

Other (please state)

How satisfied were you with:	Very Satisfied	Satisfied	Neutral	Unsatisfied	Very Unsatisfied
I was able to see a Doctor/Nurse/Mental Health Nurse quickly when I needed to
Level of courtesy and professionalism of Wellbeing at Swinburne staff
I was treated with respect and dignity
Information provided by Wellbeing at Swinburne regarding my visit
The time taken to deal with your concern
The overall service provided to you
Did you feel your issue was addressed on this visit

Did you experience any difficulty accessing Wellbeing at Swinburne?*

Yes No

If yes, how?

Would you recommend the service to others?*

Yes No

If no, why?

Your details (optional)

Full name

Student/Staff ID#

Phone

Would you like to be contacted about your feedback?*

Yes No

Preferred contact Method*

Email Phone

Please provide any additional comments you may wish to add

Disclaimer: Any information you provide to us is voluntary. We will take all reasonable steps to ensure your information is protected from modification, misuse, disclosure, loss and unauthorised access. Remember that no internet transmission is ever completely secure or error-free. Swinburne will not be held responsible for events arising from unauthorised access to your information.