Contact Us Call Now on +61452393156 We Work On The Forefront To learn more about our service offerings and industry expertise or to have one of our professionals contact you directly, please fill out the form below or submit an email. Desired Support Head Office Call Us: +61452393156 Email: dsdisability@outlook.com Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Participant DetailsName *LayoutDate / Time *Person Completing Form *-Select-ParticipantFamilyNomineeOtherName of Person Giving Feedback *Services ReceivedPlease tick the services you have received from Desired Supports: *Community Access & Social SupportPersonal CareDomestic AssistanceMeal PreparationTransport AssistanceSupport CoordinationCapacity BuildingAppointment SupportBehaviour Support AssistanceWorkshops / Community ProgramsOtherYOUR EXPERIENCE WITH DESIRED SUPPORTSLayoutQuestionsLayoutOverall support receivedOverall support received *Very HappyHappyNeutralUnhappyLayoutStaff ProfessionalismStaff Professionalism *Very HappyHappyNeutralUnhappyLayout Communication from StaffCommunication from Staff *Very HappyHappyNeutralUnhappyLayoutReliability & PunctualityReliability & Punctuality *Very HappyHappyNeutralUnhappyLayoutRespect & Dignity ShownRespect & Dignity Shown *Very HappyHappyNeutralUnhappyLayoutSupports matched your needsSupports matched your needs *Very HappyHappyNeutralUnhappyLayout Workshop/group activity experienceWorkshop/group activity experience *Very HappyHappyNeutralUnhappyRIGHTS, SAFETY & CHOICEPlease choose Yes or NoDid you feel safe while receiving supports? *-Choose--Choose-YesNoWere your choices and preferences respected? *-Choose--Choose-YesNoDid staff treat you with respect and dignity? *-Choose--Choose-YesNoDid you understand how to make a complaint or provide feedback? *-Choose--Choose-YesNoWas your privacy and confidentiality respected? *-Choose--Choose-YesNoWHAT DID YOU LIKE MOSTABOUT OUR SERVICES? *Friendly StaffReliable SupportsGood CommunicationStaff understood my needsFlexible SupportsHelped achieve goalsCultural UnderstandingEasy to contactWorkshops & ActivitiesOtherOVERALL FEEDBACKWould you recommend Desired Supports to others? *YesYesMaybeNoWould you use Desired Supports again in the future? *YesYesMaybeNoHow did you hear about Desired Supports? *Support CoordinatorPlan ManagerFriend/FamilySocial MediaGoogle SearchCommunity OrganisationWorkshop/EventOtherSERVICE CHANGES (OPTIONAL)Services CompletedReducing SupportsChanging ProviderTemporary Pause of supportsOtherADDITIONAL COMMENTS OR SUGGESTIONS (OPTIONAL)FOLLOW-UP (OPTIONAL)Would you like Desired Supports to contact you regarding your feedback?YesNoPreferred Contact Method: *PhoneEmailContact Details:CONSENT *I confirm that the information provided is based on my experience with Desired Supports.Name *Signature *Date / Time *Desired Supports Pty Ltd Registered NDIS ProviderMelbourne West| Services Across MelbourneSubmit Choose a better kind of care. Make a Referral Call Us: +61452393156dsdisability@outlook.com