01603 559255 / 01332 638099
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UNDER 11’S
OVER 11’S
FOSTERING FRIENDS
CONSULTATION GROUPS
HELP & INFORMATION
CONTACT US
Younger Children Feedback
Name
First Name
Surname Initial
Age
1. What do you think about where you live?
Please tick the words that best describe it.
Good
Fun
Stable
Comfortable
Happy
Sad
Annoying
Loud
Fantastic
Boring
Busy
Clean
Stressful
2. Who do you get on with in your home?
3. Who don't you get on with?
4. Do you see people who are important to you?
Too much
Enough
Not enough
Not at all
5. Is there anything else you want to say about this?
6. Do you want anything in your life to change or do you want any help with anything?
7. Is there anything else we should know?
Disclaimer – we may need to speak to others about this information. If there is anyone you do not want us to talk to, please note them below and explain why.
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