Golden Memories Karaoke Feedback
Please complete the below form rating your experience with Golden Memories Karaoke. Local councils require feedback to justify their subsidising the karaoke sessions.
Aged Care Facility Details
Please enter the details of your Facility
Select your Group
*
ACH Group
ACSAG Group
Allity Group
Ananda Group
Anglicare Group
Auscare Group
Bene Group
Blue Dawn Health Care
BUPA Group
Calvary Group
ElderCare Group
Estia Health Group
Life Care Group
Regis Aged Care Group
Resthaven Group
Southern Cross Group
St Louis Aged Care Group
Uniting Communities
Uniting SA
Group NOT listed (will open an add box)
Not Part of a group
Enter the group to be added
*
Enter Your Facility name
*
Enter Your Facility SUBURB
*
How many Residents do you have in your Facility
*
Please enter a number
Your Name
*
First Name
Last Name
E-mail
*
Facility Phone Number
*
-
Area Code
Phone Number
About the Golden Memories Karaoke Session
Date of the Karaoke session
-
Day
-
Month
Year
Date
Approx No. of Residents ATTENDED the Karaoke Session
*
Please enter a number
Did the Golden Memories Karaoke session meet your expectations
*
It was great
Could have been better
How could the sessions be made better ?
*
Would you recommend Golden Memories Karaoke a colleague or a friend?
*
Yes, definitely
No
Why would you not recommend Golden Memories
*
Would you re-book Golden Memories Karaoke sessions?
*
Yes we would pay $100 per session if council support was not available
Would only re-book if receiving council support
No, we would not re-book
If Council support was NOT available, how much would you pay
*
The normal charge for a Karaoke session is $100
Why would you not re-book?
*
The Karaoke session went for about 60 minutes?
*
Just right
Too Short
How long should the Karaoke session go for?
*
Level of Interaction with the residents?
*
Great
Not as much as expected
Low
Were the residents happy afterwards
*
Very Happy
No more than usual after entertainment
Not really
Overall, were you able to see and hear the presentation well?
*
Yes
No
What problems did you encounter?
Final Thoughts?
Any final comments?
Submit Form
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm