Neftaly Therapeutic Psychosocial Support Programme
Client Feedback File
This Feedback File ensures service quality improvement, accountability, beneficiary participation, and programme impact measurement.
NEFTALY THERAPEUTIC PSYCHOSOCIAL SUPPORT PROGRAMME
CLIENT FEEDBACK FILE
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 |
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 | ☐ | ☐ | ☐ | ☐ |
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 | ☐ | ☐ | ☐ | ☐ |
SECTION 4: SERVICE IMPACT FEEDBACK
Since joining the programme:
| Area | Improved | No Change | Declined |
|---|---|---|---|
| Emotional Wellbeing | ☐ | ☐ | ☐ |
| Stress Management | ☐ | ☐ | ☐ |
| Confidence | ☐ | ☐ | ☐ |
| Family Relationships | ☐ | ☐ | ☐ |
| Social Participation | ☐ | ☐ | ☐ |
SECTION 5: OPEN CLIENT COMMENTS
What helped you the most?
What challenges did you experience?
What improvements would you suggest?
SECTION 6: COMPLAINTS & CONCERNS REGISTER
| Complaint Raised | Yes ☐ | No ☐ |
|---|
If YES:
| Description | Action Taken | Responsible Person | Resolution Date |
|---|
SECTION 7: CLIENT RIGHTS CONFIRMATION
Client confirms that:
☐ Services were voluntary
☐ Confidentiality was respected
☐ Rights were explained
☐ No discrimination experienced
Client Signature: _________________________
Date: ____________________________________
SECTION 8: PRACTITIONER RESPONSE
| Feedback Category | Action Required | Responsible Staff | Deadline |
|---|
Practitioner Name: __________________
Signature: _________________________
SECTION 9: PROGRAMME IMPROVEMENT TRACKING
| Issue Identified | Corrective Action | Responsible Person | Completion Status |
|---|
SECTION 10: FEEDBACK SUMMARY REPORT
(To be completed monthly or quarterly)
| Period | Feedback Forms Received | Positive Feedback | Complaints | Actions Implemented |
|---|
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.
✅ Recommended Feedback Collection Frequency
| Stage | Timing |
|---|---|
| After First Session | Optional |
| Mid-Programme | Recommended |
| Programme Exit | Mandatory |
| Follow-Up | 3–6 Months |
✅ File Divider Structure
Client Feedback File
│
├── Feedback Forms
├── Satisfaction Surveys
├── Complaints Records
├── Practitioner Responses
├── Improvement Actions
└── Feedback Summary Reports
✅ DSD & Donor Compliance Benefits
This Feedback File supports:
- Beneficiary Participation Evidence
- Service Quality Monitoring
- Programme Improvement Planning
- Accountability & Transparency
- Outcome Verification
