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

MM slash DD slash YYYY
Following the support provided via CLICS, my situation has improved.(Required)
Please select one of the following options:
I am satisfied with the support provided(Required)
Please select one of the following options:
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:
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:
I feel connected to people I can ask for help and support.(Required)
Please select one of the following options:
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:
(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).