Client Feedback Form

 

At Adelaide Care Solutions our aim is to ensure that we provide Clients with a high standard of service and that we consistently meet and exceed your expectations. Please take a moment to share with us your experience of using an Adelaide Care Solutions staff member.

Facility Details:
Facility Name :
Staff Name:

 

Adelaide Care Solutions staff member:

Name:
Shift Date:
Shift Start / Finish Time:
Location:

 

Please rate any or all of the following:

Excellent
Good
Fair
Poor
Unsatisfactory
Punctuality
Communication
Flexibility
Presentation
Attitude
Reliability
Documentation
Clinical Competence
OHS&W

 

Would you be happy for this staff member return to your facility?

 

Yes: No:

 

We value any other feedback/comments/suggestions or complaints:

We also offer you the choice to speak to our friendly team at Adelaide Care Solutions.
You can contact us on 8332 9555