Student Feedback Form - Mental Health and Wellness - Wellness - Current Students

Feedback Format*

Name*

First Last

Email (Carleton Email)*

Service or interaction for which you are providing feedback*

Health Promotion
Wellness Desk

Date of service or interaction (if known)

Which type of interaction?*

Commitment to Service Excellence

The Office of the Associate Vice President (Student Health and Wellness) embraces principles of Service Excellence in all that we do by striving to be caring, professional, reliable, courteous and treating each person as an individual.

For the interaction you are commenting on, the staff member assisting you was:*

Was the issue you were seeking help with resolved?*

Yes
No

If not, were you provided feedback or resources for follow-up?*

Yes
No

Commitment to Inclusive Culture

The Office of the Associate Vice President (Student Health and Wellness) values respectful, diverse, accessible and equitable environments and continuously strives towards inclusion.

For the interaction you are commenting on, the staff member assisting you was:*

Additional Feedback

I would rate my overall experience with this interaction as:*

Please tell us why you answered this way:

What else would you like to share to help enhance exceptional programming, services, and initiatives?

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Helpful
Considerate
Knowledgeable

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
I felt respected
I felt my perspective mattered
I felt I was treated fairly
I felt supported
Services were accessible for my needs