Waypoint Community Member Survey
Bennie Stadler: Waypoint Office & Care Line Tel. nr. 041-360 9742
Website http://waypoint.org.za
Email address *
Name or anonymous *
Your answer
Size of family/people with you *
Your answer
Date:
MM
/
DD
/
YYYY
Telephone Number *
Your answer
1. I don’t experience unusual need for spiritual support *
2. I don’t experience unusual need for emotional support *
3. I don’t experience unusual loneliness or need support for other stress-inducing factors (such as relationship conflicts) *
4. I don’t feel bored or without sense of purpose or I don’t feel of value to others *
5. I don’t need food parcel support or have other urgent life threatening need *
6. I’m still employed or working from home and busy *
7. I would like to help or get involved somehow with the above-mentioned needs. *
Can we call you? *
Other comments?
Your answer
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