Neftaly Therapeutic Psychosocial Support Programme

Client Feedback File

This Feedback File ensures service quality improvement, accountability, beneficiary participation, and programme impact measurement.

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NEFTALY THERAPEUTIC PSYCHOSOCIAL SUPPORT PROGRAMME

CLIENT FEEDBACK FILE

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SECTION 1: CLIENT FEEDBACK COVER PAGE

Item	Information
Client Name
Client File Number
Programme Site
Practitioner
Service Received
Feedback Date
Feedback Method	☐ Interview ☐ Written ☐ Online ☐ Telephone

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SECTION 2: SERVICE EXPERIENCE FEEDBACK

Please rate the following services:

Service Area	Excellent	Good	Fair	Poor
Staff Respect & Professionalism	☐	☐	☐	☐
Confidentiality Maintained	☐	☐	☐	☐
Counselling Support Quality	☐	☐	☐	☐
Emotional Support Provided	☐	☐	☐	☐
Accessibility of Services	☐	☐	☐	☐
Safety During Sessions	☐	☐	☐	☐
Programme Environment	☐	☐	☐	☐

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SECTION 3: CLIENT SATISFACTION ASSESSMENT

Statement	Strongly Disagree	Disagree	Agree	Strongly Agree
I felt listened to	☐	☐	☐	☐
I was treated with dignity	☐	☐	☐	☐
Services helped my wellbeing	☐	☐	☐	☐
Staff explained services clearly	☐	☐	☐	☐
I would recommend this programme	☐	☐	☐	☐

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SECTION 4: SERVICE IMPACT FEEDBACK

Since joining the programme:

Area	Improved	No Change	Declined
Emotional Wellbeing	☐	☐	☐
Stress Management	☐	☐	☐
Confidence	☐	☐	☐
Family Relationships	☐	☐	☐
Social Participation	☐	☐	☐

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SECTION 5: OPEN CLIENT COMMENTS

What helped you the most?

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What challenges did you experience?

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What improvements would you suggest?

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SECTION 6: COMPLAINTS & CONCERNS REGISTER

Complaint Raised	Yes ☐	No ☐

If YES:

Description	Action Taken	Responsible Person	Resolution Date

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SECTION 7: CLIENT RIGHTS CONFIRMATION

Client confirms that:

☐ Services were voluntary
☐ Confidentiality was respected
☐ Rights were explained
☐ No discrimination experienced

Client Signature: _________________________
Date: ____________________________________

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SECTION 8: PRACTITIONER RESPONSE

Feedback Category	Action Required	Responsible Staff	Deadline

Practitioner Name: __________________

Signature: _________________________

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SECTION 9: PROGRAMME IMPROVEMENT TRACKING

Issue Identified	Corrective Action	Responsible Person	Completion Status

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SECTION 10: FEEDBACK SUMMARY REPORT

(To be completed monthly or quarterly)

Period	Feedback Forms Received	Positive Feedback	Complaints	Actions Implemented

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SECTION 11: CONFIDENTIALITY DECLARATION

All feedback information is protected under:

• Protection of Personal Information Act (POPIA)
• Social Service Ethical Standards
• Client Rights & Confidentiality Policies

Access limited to authorised programme personnel.

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✅ Recommended Feedback Collection Frequency

Stage	Timing
After First Session	Optional
Mid-Programme	Recommended
Programme Exit	Mandatory
Follow-Up	3–6 Months

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✅ File Divider Structure

Client Feedback File
│
├── Feedback Forms
├── Satisfaction Surveys
├── Complaints Records
├── Practitioner Responses
├── Improvement Actions
└── Feedback Summary Reports

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✅ DSD & Donor Compliance Benefits

This Feedback File supports:

• Beneficiary Participation Evidence
• Service Quality Monitoring
• Programme Improvement Planning
• Accountability & Transparency
• Outcome Verification

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