OUR SERVICES:
Which, if any, of our services have you used in the last 12 months?
Our Advisor ServiceA KASBAH Independent Living Project (Seabrooke House/Hattie Webb House/Rochester Road/Maddison House/Gingerbread House/Shortbread House) including day service & respiteOutreach SupportOur Charity ShopDisablement Information & Advice Line (DIAL)I had help from you in some other way (if so, can you say briefly what sort of help this was e.g. signposting to another agency such as social services, Carers First?)None of the above

Comments:

Do you feel that over the last year our level of service has been (Tick one box only):
Much worseWorseThe sameBetterMuch better

From your experience of KASBAH, please comment on any strengths such as Advisor service/DIAL/Outreach/ Day service/staff professionalism etc:

From your experience of KASBAH, please comment on any poor areas or improvements that could be made:

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1. OUR NEWSLETTER:

How do you receive our newsletter?
I don’t receive it but would like toI receive it by postI receive it by e-mailI have chosen not to receive it

(If you wish to change whether or how you receive our newsletter, please write your new choice in this box & put your correct details in section 3)

Are you generally satisfied with our newsletter content?
YesNo

Can you suggest any ways in which we might improve it?

Would you consider writing an article of your own experience(s) to share with others?
YesNo

(If yes, please email admin@kasbah.org.uk or send by post to the usual address).

Please leave this field empty.

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2. OUR INDEPENDENT LIVING PROJECTS & DAY SERVICES:

Are you a young adult (i.e. between 18 & 40 years old) OR do you care for a young adult?
YesNo

If so, are you aware of our Independent Living Projects (Seabrooke House, Hattie Webb House, Rochester Road, Maddison House, Gingerbread House) & the services they provide? Did you know we also supply day outreach support in Independent Living Skills in your home within a radius of approx 30 minutes travelling from the Bluewater area?
YesNo

If you would like further information about these, please fill in section 3 & select 'Yes'.

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3. YOUR DETAILS:

Do we have any of your information listed incorrectly, (for instance on your address label)?
If you would like us to check or confirm your details, please write them clearly below:

Gender:
—Please choose an option—MaleFemale

Your name:

Date of Birth:

Home Tel No:

Work Tel No:

Mob Tel No:

Your email

Your Full Address & Postcode:

If you have any other comments about KASBAH generally or our services please continue below:

By submitting this form you agree to the storing and processing of your personal data by Kasbah as described in our Privacy policy.

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