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General Feedback Form 


Overview & Purpose

The collection of data from this questionnaire helps us understand where the strengths and weaknesses are within Victoria’s healthcare system.


Personal information will only be seen by select See Spring Staff who are compiling results.

Updates on data collected will be posted on our Website. This information will never be posted with people’s names or other identifying information. We will never share this information with others and appreciate your trust.



  1. We are looking for your input so that we can advocate for changes that are needed.

  2. We want to understand where See Spring can provide additional support for people seeking Mental Wellness resources.

Materials Needed

  1. Fill out and submit online.

  2. Print out the form and send it to us.


With the results of the Questionnaire we will create reports and recommendations for change.  

The data from the yes/no/maybe questions can create charts that show what is really going on in our community.  Story-type questions may also be used this way but they can also be used to describe our injustices in a human way.


Please click here to fill out the Questionnaire online.

Please click here to find a printable version.

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