Name of Meeting?

Date of meeting?

Whilst you were taking part were you:

1. Given all the information you needed?

Yes
No

2. Was it in plain language and easy to understand?

Yes
No

3. Did you feel able to express your views and take an active part?

Yes
No

3b. What could have been done to improve this?

4. Did you feel your views and opinions were listened to?

Yes
No

5. Did you feel your contribution was valued?

Yes
No

6. Were you treated with courtesy and respect?

Yes
No

7. Were your personal needs met?

Yes
No

8. What could have been improved?

9. Regarding this meeting what difference do you feel your contribution has made?

10. In considering your involvement in these meetings would you say?

I felt I was ONLY able to bring my own personal views to the meeting?
I was able to share the views and opinions of others at the meeting, as well as my own?

11. Have you passed feedback of the meeting on to anyone else?