Mental Health Service Directory

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Feedback Form

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We hope you found all the information you needed in this Service Directory.

Please spare a moment of your time to answer the questions below. This will help us to find out if the Service Directory has been useful and whether we can improve in the future.

Should you wish to comment on any mental health services you have received within the RCT or MT areas, there is space to do so.

We are not collecting personal data; - all information that we gather is to aid ongoing development and improvement of the Directory only.

1. Did you find the Service Directory useful?	Yes	No
2. Easy to use?	Yes	No
3. Easy to understand?	Yes	No
4. Are you aware of any mental health services not listed here? (please list below)	Yes	No
Comment:

Comments about the guide:

Comments about mental health services you have received within RCT and MT:

Your details

5. Are you a service user?	Yes	No
6. Do you work in the field of mental health?	Yes	No

EQUAL OPPORTUNITIES MONITORING

Please tick the appropriate boxes
GENDER	Female	Male
DISABILITY
Do you consider yourself to have a disability as defined by the Disability Discrimination Act 1995: ‘a physical or mental impairment which has a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day duties’?	Yes	No
ETHNIC ORIGIN
Which group below do you most identify with?	White
	Asian	Bangladeshi
		Indian
		Pakistani
		Any other Asian background
	Black	African
		Caribbean
		Any other Black background (specify if you wish)
	Chinese
		(specify background if you wish)
	Mixed Ethnic Background	Asian and White
		Black African and White
		Black Caribbean and white
		Any other mixed ethnic background (specify if you wish)
	Other	(specify if you wish)
NATIONALITY
Which group below do you most identify with?
Welsh
English
Scottish
British or Mixed British
Irish

Other (Please specify if you wish)