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* 1. How did you hear about Headwaters Family Visit Centre?

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* 2. Staff provided a clear orientation to the program for both myself and my children.

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* 3. I felt welcomed and was treated respectfully. I was listened to and felt understood.

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* 4. Staff provided a safe and neutral setting for my child's visits and/or exchanges.

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* 5. Staff were supportive and helpful before, during and after visits.

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* 6. The service I received through Headwaters Family Visit Centre made a positive difference in my and/or my child's life.

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* 7. Please rate your overall satisfaction with the service you received from Headwaters Family Visit Centre.

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* 8. Do you have any suggestions that would help us to improve our service?

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* 9. Please feel welcome to add any other comments you have about our service.

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