SayPro field feedback forms

SayPro Field Feedback Form

Project Name: __________________________________
Date: ____ / ____ / ______
Location / Site: ________________________________
Facilitator / Officer Name: _______________________
Type of Activity:
☐ Training
☐ Outreach / Awareness
☐ Consultation
☐ Service Delivery
☐ Other: _______________

🧍 Section A: Respondent Information (Optional)

• Name (Optional): __________________________
• Age: __________
• Gender: ☐ Female ☐ Male ☐ Other ☐ Prefer not to say
• Residence / Community: _____________________
• Are you a returning participant? ☐ Yes ☐ No

✅ Section B: Satisfaction Assessment

Please rate the following aspects from 1 (Very Poor) to 5 (Excellent):

💬 Section C: Open Feedback

1. What did you like most about today’s session?
2. What could we improve for future activities?
3. Do you feel this activity met your needs or expectations? Why or why not?

🧠 Section D: Additional Comments / Suggestions

(Optional – leave blank if none)

📎 Section E: Follow-Up Interest

Would you like to be contacted about future SayPro programs?
☐ Yes
☐ No

If yes, please provide contact info (phone or email):

🔒 Confidentiality Notice

Your responses are confidential and will be used only to improve SayPro’s programs and services.