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Client Evaluation Form

We invite you to evaluate the service you have received.


  • Your identity is always kept confidential unless you give your permission otherwise
  • The information that you provide should be given voluntarily
  • There is no requirement to record your name on this form

If you have any queries, please contact:

PO Box 26 641
Auckland 1344
09 623 2950 or 0800 SELF HELP

Please complete the following:

  • Are there any comments of suggestions you would like to make about your workplace environment?

    The information you provide will be collated with other comments and suggestions and be included as part of a confidential and neutral feedback report to your company.