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Feedback Form

Valued Client,

Carefor’s primary goal is to continue to provide services that help our clients in retaining the best possible quality of life that we can. To continue to do that, we’d like to hear from you! Your opinion is important to us and helps to shape the services & programs that we provide.

Please take a few minutes to answer the following questions using the most appropriate answer – please also provide any comments that you feel might help improve the services that you receive. This survey is anonymous, and as a result, there is no need for you to identify yourself. The information that you provide will be used solely for quality improvement purposes.

On behalf of Carefor Health & Community Services, we thank you for your time. Your decision to participate and your responses will not impact the care or services that you receive.

Service Selection

Please indicate the Carefor location & service or program that you are providing your feedback about.
Care in a residential setting
Homecare Services
Community Support Services
Are you involved in making decisions about the care or services you receive?
Are you, and you family members treated with courtesy and respect?
Do you observe staff regularly washing their hands with either soap and water or alcohol gel?
Do the services that you receive enhance your quality of life?with either soap and water or alcohol gel?
Do the services you receive help you to continue living safely in the setting of your choice?
Would you recommend Carefor to your friends and family?
If you or a family member would like an active voice in the further development of services and programs, please provide your contact information below.