Online Searchable Database Feedback Form


Database user friendliness:

1. Was the information satisfactory?


2. Was the information easily accessible?


3 .Was the database easy to navigate?



Quality of service providers:

1. Did you find the type of service provider you were looking for?


2. Was it easy to access the service provider listed?


3. Was the service provider helpful and friendly?


4. Were your concerns addressed?


5. How likely are you to go back to the same service provider? (Please mark on a scale of 1-10, with 1 being the least likely and 10 most likely:)


6. How likely are you to refer the service provider to someone else? (Please mark on a scale of 1-10, with 1 being the least likely and 10 most likely:)



Suggestions for new service providers to be included:

1. Do you think the service providers listed here are adequate?


If no, what is missing?


2. Do you think we need to list other types of service providers?


If yes, what types?


3. Do you know of any service providers who would be suitable for inclusion in the database?


If yes, please provide the following information :

Name of service provider :


Location :


Academic / professional qualification :


Nature of service provided :


Contact information (phone) :


Contact information (email) :


In your opinion is the service provider knowledgeable, skilled and sensitive about queer issues in their field and in general?


Any additional remarks?



Name (optional) :


Email (optional) :


Feedback :


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