LifetouchCare Feedback Form

Name:

Email:

Relation to Service User (e.g., client, family member, advocate, staff):

I consent to being contacted about my feedback (if contact details are provided).

Service User Name:

Care Worker Name (if applicable):

Aspect	1	2	3	4	5
Punctuality & reliability	1	2	3	4	5
Professionalism & friendliness	1	2	3	4	5
Personal care (e.g., washing, dressing)	1	2	3	4	5
Medication support (if applicable)	1	2	3	4	5
Respect for dignity & privacy	1	2	3	4	5

Were care workers clear and respectful?
YesNo

Were your concerns addressed?
YesNo

Providing compassionate and personalized home care services in Wolverhampton. Your comfort and well-being are our top priorities.

Feedback Form