HOMESHARE MONITORING CHECK-IN - SUPPORTMATCH HOMESHARE

HOMESHARE MONITORING QUESTIONNAIRE

HOMESHARE MONITORING CHECK-IN

Welcome to your monthly Homeshare Monitoring Check-In. This is a key opportunity for you to share insights and address any concerns with a Supportmatch Coordinator. Your feedback is vital in shaping and improving your Homeshare arrangement! We are committed to ensuring a harmonious and beneficial experience for all our Householders and Homesharers. It is an important requirement of your agreement with Supportmatch to take a moment to complete the questionnaire, as it helps us to continually monitor and support your arrangement. Please remember that our team is always available to assist with any aspect of your Homeshare arrangement. Your well-being is an absolute priority for us, and we are here to help with any challenges you may encounter.

I AM A:*

Please select

Please select
HOUSEHOLDER
HOMESHARER

FIRST NAME*

LAST NAME*

EMAIL*

Pleaser Confirm Email

QUESTIONNIARE INSTRUCTIONS

PLEASE ENSURE YOU COMPLETE ALL SECTIONS

Please answer openly and honestly by moving the slider from: VERY UNHAPPY to VERY HAPPY. Use the box for notes below each question to provide any information that you feel would help us to assist you.

1. HOW SATISFIED ARE YOU WITH YOUR HOMESHARE ARRANGEMENT ?*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

1. Feedback/Comments*

2. GENERALLY, ARE YOUR EXPECTATIONS UNDER HOMESHARE BEING MET?*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

2. Feedback/Comments*

3. LIVING ARRANGEMENTS & CONDITIONS (Privacy, Shared Space, Other)*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

3. Feedback/Comments*

4. COMMUNICATION & ENGAGEMENT WITH YOUR HOMESHARE PARTNER (Dignity, Respect, Companionship, Loneliness & Isolation) ?*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

4. Feedback/Comments*

5. SAFETY & WELL-BEING (Do you feel safe and secure in your arrangement)*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

5. Feedback/Comments*

6. LEVEL OF INTERACTIONS & COOPERATION*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

6. Feedback/Comments*

7. INDEPENDENCE & FREEDOM*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

7. Feedback/Comments*

8. ARE YOU SATISFIED WITH THE SUPPORT, MONITORING & OVERSIGHT YOU RECEIVE FROM SUPPORTMATCH?*

Please select

Please select
VERY UNHAPPY
FAIRLY UNHAPPY
NEUTRAL
FAIRLY HAPPY
VERY HAPPY

9. Feedback/Comments*

Please use this space to provide any additional feedback related to your experience

By submitting your Monitoring Check-In Questionnaire Form you agree to give Support&Match CIC and Supportmatch Homeshare Ltd permission to use the information provided for the purposes of Monitoring your Homeshare Arrangement, and to better improve our services and Homeshare in general.

SUBMIT DATE (Admin)

IMPORTANT NOTE

It may take up to 30 seconds to submit your form. This is dependent on your internet connection and browser you are using.

Support&Match CIC (Community Interest Company) and Supportmatch Homeshare Ltd are part of the Supportmatch Group, Registered Companys in England & Wales, with respective Company Registration Numbers 12623910 and 10641187. Supportmatch Homeshare © 2024. All rights reserved.