True Friends Respite Survey
Please provide us with information on how you feel the weekend went for your camper(s). We look forward to having your feedback as it will allow us to better serve your camper(s) and other campers who utilize our service. We are constantly striving to provide an excellent service to our clients, and this feedback helps us to do just that.
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Name of Camper(s) *
Your Name *
Relationship to Camper(s)
Please Rank your experience with the weekend.
4= Very Satisfied, 3= Satisfied, 2= Unsatisfied, 1= Very Unsatisfied
1
2
3
4
Variety and quality of Activities.
Personal and medical care provided.
Food provided.
Facilities.
Care of belongings.
Overall experience.
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Additional Comments
How has Respite impacted your camper(s) in each of the following ways?
3=Increased, 2=No Change, 1=Decreased
3
2
1
Level of independence.
Social interactions.
Willingness to try new things.
Ability to transition between activities.
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Additional Comments
Please share some of the positive experiences that have emerged from your time with us and how we can improve our services:
Will you be a reference for us?
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May we contact you with regards to the information provided in this survey?
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Thank You for your feedback, we will use it to become a better program and service.
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