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GLOUCESTER.GOV.UK
The Homeless Service Customer Satisfaction Survey
The Homeless Person's Unit is based in Gloucester City Council and aims to provide you with the best possible service when you need us. Your comments, good or bad will help us to monitor the service we provide and identify areas for improvement. We would be grateful if you could spare the time to complete the following form:
Homeless Interview
1.In general, how satisfied or dissatisfied were you with your homeless interview?
Very Satisfied
| Fairly Satisfied
| Neither Satisfied or Dissatisfied
| Fairly Dissatisfied
| Very Dissatisfied
If dissatisfied please explain why:
2.How satisfied or dissatisfied were you with the information/advice you received about your housing options?
Very Satisfied
| Fairly Satisfied
| Neither Satisfied or Dissatisfied
| Fairly Dissatisfied
| Very Dissatisfied
If dissatisfied please explain why:
Telephone Service
3. How easy or difficult was it to contact us?
Very Easy
| Fairly Easy
| Neither Easy or Difficult
| Fairly Difficult
| Very Difficult
If you found it difficult, please explain why:
4. How satisfied or dissatisfied were you with the information and/or advice you were given on the phone?
Very Satisfied
| Fairly Satisfied
| Neither Satisfied or Dissatisfied
| Fairly Dissatisfied
| Very Dissatisfied
If dissatisfied please explain why:
Correspondence
5. If we have sent you a letter how easy or difficult was it to understand?
Very Easy
| Fairly Easy
| Neither Easy or Difficult
| Fairly Difficult
| Very Difficult
If you found it difficult, please explain why:
Accommodation
6. If the Homeless dept. has provided you with temporary accommodation e.g. B&B, how satisfied are you with it?
Very Satisfied
| Fairly Satisfied
| Neither Satisfied or Dissatisfied
| Fairly Dissatisfied
| Very Dissatisfied
If dissatisfied please explain why:
7. If you have been housed, What type of accommodation are you now in? Please tick:
Housing Association
| Council
| Short Term Let
| Privately Rented
8 How satisfied are you with the accommodation?
Very Satisfied
| Fairly Satisfied
| Neither Satisfied or Dissatisfied
| Fairly Dissatisfied
| Very Dissatisfied
If dissatisfied please explain why:
9. Overall, what do you think of the service you received from the Homeless Dept.?
Excellent
| Very Good
| Good
| Poor
| Very Poor
If dissatisfied please explain why:
We want to make sure we hear everyone's views, so please answer the following questions about you and your family.
10. Which age group do you fit into?
15-20
| 21-30
| 31-40
| 41-50
| 51-60
| 61-70
| 71-80
| 80+
11. Which family group do you consider yourself to be in?
Single
| Couple, no dependants
| Couple pregnant
| Single pregnant
| Lone Parent
| Family
12. Which of these ethnic groups do you consider you belong to?
White British
Black African
White and Black Caribbean
White Irish
Black Caribbean
White and Black African
White Other
Black Other
White and Asian
Indian
Pakistani
Bangladeshi
Asian Other
Chinese
Other Ethnic Origin
Please State:
13. Do you consider anyone in your household to be disabled?
Yes
| No
14. Any Other Comments?
Name
Address
E-mail address:
Thank you for taking the time to complete this form. Please click Send to submit the form to us.
If you would like to discuss this further please contact: The Homeless Co-ordinator tel.01452 396517