Referrer Satisfaction Survey
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1.
Please select your role:
(Required.)
General Practitioner (GP)
School Counsellor
Community Mental Health Service
Community Based Organisation
Other (please specify)
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2.
Please select the primary reason for your referral:
(Required.)
Mental Health Support
Focused Psychological Intervention
Alcohol & Other Drug Support
Physical Health Support
Vocation or Education Support
Groups
Other (please specify)
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3.
How satisfied were you with our initial response time to your referral?
(Required.)
Very satisfied
More than satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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4.
How satisfied were you with the quality of information provided to you following the referral? (i.e. wait-times, assessment process, decision on referral acceptance)
(Required.)
Very satisfied
More than satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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5.
If the person who referred was offered an initial appointment, how satisfied were you with the availability?
(Required.)
Very satisfied
More than satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
Not applicable
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6.
Overall, how satisfied were you with the way we managed your referral?
(Required.)
Very satisfied
More than satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
7.
We welcome any suggestions to improve our referral process:
Current Progress,
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