EmailMe Form - SEWB Feedback Survey

SEWB Feedback Survey

We hope you enjoyed our service at Kurbingui Youth and Family Development. Please take a moment to share your thoughts on how we served you.

This is a CONFIDENTIAL survey for people who have received support from our Social Emotional Wellbeing (SEWB) team, this survey will take about 5 minutes to complete.

All survey responses are reviewed by our Management Team and final results about Social Emotional Wellbeing (SEWB) Support may be published in research journals, presented at conferences, or made available to the public.

Any questions, concerns or feedback about the survey please contact our Social Emotional Wellbeing (SEWB) Coordinator Kurbingui Youth and Family Development on (07) 3156 4800 or Email: sewb@kurbingui.org.au

Thank you.
Program Coordinator
Social Emotional Wellbeing (SEWB)

Which cultural group do you identify with?
Aboriginal
Torres Strait Islander
Both
Non Indigenous
Culturally and Linguistically Diverse
Other
Please tick I am:
Female
Male
Intersex
Transgender
Non-Binary
Brother Boy
Sister Girl
Other
How long were you involved with this program?
Less than 1 month
6 months
7-12 months
1-2 years
More than 3 years

How satisfied are you with the Wellbeing Team in the following areas:

	Very Satisfied	Somewhat Satisfied	Somewhat Unsatisfied	Very Unsatisfied
Providing help and support	1	2	3	4
Being caring and understanding	1	2	3	4
Providing useful advice and Information	1	2	3	4
Treating you/your family with respect and dignity	1	2	3	4
Being professional	1	2	3	4
Connecting to Community and Culture	1	2	3	4

How likely is it that you would recommend Social Emotional Wellbeing (SEWB) to a family member, friend or colleague?

Not at All
1

2

3

4

5

6

7

8

9

10

Very Likely
What does Social Emotional Wellbeing (SEWB) do well?
What could we do to improve?
Anything else you would like to tell us?

As a result of working with the Social Emotional Wellbeing Program (please tick):

	Yes	Unsure	No
I know more about the needs of my child/ren/family.
I feel more able to keep myself and my child/ren/family safe.
I know more about Aboriginal and Torres Strait Islander services in my area that can provide help and support.
I feel more confident to find appropriate support services in the future if necessary.
I feel more connected to community and services that can support me.

Would you be happy to be contacted to discuss your feedback?
Yes
No
Would you be happy to be contacted to discuss your feedback?
Yes
No
Optional
Name
Phone
Address

Street Address City State / Province / Region Postal / Zip Code