Disability Solutions 
West Midlands

We hope your experience with us was favorable, either way we would really appreciate your feedback.

Date *

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Post Code *

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How did we Help you. *

How would you rate the help you received from us 0= extremely poor and 10 = excellent *

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Why have you given us this rating? Please be honest, if there was a problem, we’d like to know so we can make changes and improve our service.rea *

After you had received support from Disability Solutions, how did you feel? 1 Extremely Anxious, 5 No Anxiety *

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How was the problem or issue you had affecting you and your life? We know this may be difficult for you to think back on, but please be as honest as you are able. *

Do you have any ideas about how Disability Solutions could improve or any ideas for new services we could provide? For example, are there any issues you are facing which you think we could help with? *

IT and social media. Please tick all that apply: *

I have a home computer/laptop/tablet

I have Wi-fi/internet access

I don’t have access to the internet or social media

I would not want to use the internet

I don’t use the internet or social media but I’d be interested in finding out how to.

Is there anything else you would like to tell us? *

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