We hope you have benefited from this scheme and would like some feedback
from you. Please fill out this short questionnaire.

Feedback Form

Voucher number: --
   
OR Postcode:   
and door number:
   
Today's date:
   
Borough:
   
Have you continued to use real nappies? Yes   No
   
Which nappies do you use?
   
Which nappy supplier did you use?
   
Was your nappy supplier impartial? Yes   No
   
Ethnic origin
   
Are you satisfied with:
support/information you
received?
Highly  Somewhat  Mostly  No
your nappy supplier? Highly  Somewhat  Mostly  No
the nappies/service you    
are using?
Highly  Somewhat  Mostly  No
   
Please add any further comments:
   
Please tick if you are happy for us to contact you for further feedback:
 
 
Now please submit your form.