Older Adults Day Care – Referrer Questionnaire

Overview

Birmingham City Council Older Adults Day Care Service will always try to provide you and the person you have reffered to us; for with the best possible service, but we can never be perfect.

We want to know your views about the Centre and the impact it has upon your workload.

Please answer these questions so you can tell us where we can improve our service to you. This should not take you long to complete. 

Please help us to provide a good service by filling in this questionnaire. There are no right or wrong answers.

You can either complete the form manually or complete the form on line.

Data Protection Act 1998 - The personal information on this form will be kept safe and is protected by law. You can see more information about data Protection on our website at: http://www.birmingham.gov.uk/privacy

If you would like to speak to us about this questionnaire, please contact: Sueb Jabbar 0121 464 6235

Please tick one box for each answer in a single box which is closest to the way you feel.

Thank you for your help.

What happens next

This information will be used to improve and devlop the service