Central Locality Integrated Care Service (CLICS) Patient Questionnaire Advanced Practitioner Pathway Please provide the answers that best describe your experience of the service you have received from the CLICS team Your name (optional): Your GP practice or Community Connector (optional): Today’s date: MM slash DD slash YYYY Following the support provided via CLICS, my situation has improved.(Required)Please select one of the following options: Strongly Agree Agree Neutral Disagree Strongly Disagree Don't Know I am satisfied with the support provided(Required)Please select one of the following options: Strongly Agree Agree Neutral Disagree Strongly Disagree Don't Know I would be likely to recommend the service to friends and family if they need similar services(Required)Please select one of the following options: Strongly Agree Agree Neutral Disagree Strongly Disagree Don't Know I know about services, activities and support I can access that are appropriate to me (this could be cultural, religious, shared values or interests).(Required)Please select one of the following options: Strongly Agree Agree Neutral Disagree Strongly Disagree Don't Know I feel connected to people I can ask for help and support.(Required)Please select one of the following options: Strongly Agree Agree Neutral Disagree Strongly Disagree Don't Know I felt involved in the setting of my goals and/or the development of my care plan.(Required)Please select one of the following options: Strongly Agree Agree Neutral Disagree Strongly Disagree Don't Know Please use the box below to provide any other comments and/or feedback.(If you wish for any action to be taken or feedback to be forwarded regarding the service you have received, please include both your name and your GP practice and/or Community Connector’s name at the top of this form).