Report a serious incident survey

What is your charity number or name?

1. How easy was it to complete the report a serious incident form? *

Please include any comments you may have:

2. Please select the number below that best represents your view for each statement (1 suggests you strongly disagree and 5 suggests you strongly agree) *

	1 (Strongly disagree)	2	3	4	5 (Strongly agree)
I could complete the service in one visit	I could complete the service in one visit 1 (Strongly disagree)	I could complete the service in one visit 2	I could complete the service in one visit 3	I could complete the service in one visit 4	I could complete the service in one visit 5 (Strongly agree)
I found the service unnecessarily complex	I found the service unnecessarily complex 1 (Strongly disagree)	I found the service unnecessarily complex 2	I found the service unnecessarily complex 3	I found the service unnecessarily complex 4	I found the service unnecessarily complex 5 (Strongly agree)
I thought the service was easy to use	I thought the service was easy to use 1 (Strongly disagree)	I thought the service was easy to use 2	I thought the service was easy to use 3	I thought the service was easy to use 4	I thought the service was easy to use 5 (Strongly agree)
I think that I would need the support of a technical person to be able to use this service	I think that I would need the support of a technical person to be able to use this service 1 (Strongly disagree)	I think that I would need the support of a technical person to be able to use this service 2	I think that I would need the support of a technical person to be able to use this service 3	I think that I would need the support of a technical person to be able to use this service 4	I think that I would need the support of a technical person to be able to use this service 5 (Strongly agree)
I found the various functions in this service were well integrated	I found the various functions in this service were well integrated 1 (Strongly disagree)	I found the various functions in this service were well integrated 2	I found the various functions in this service were well integrated 3	I found the various functions in this service were well integrated 4	I found the various functions in this service were well integrated 5 (Strongly agree)
I thought there was too much inconsistency in this service	I thought there was too much inconsistency in this service 1 (Strongly disagree)	I thought there was too much inconsistency in this service 2	I thought there was too much inconsistency in this service 3	I thought there was too much inconsistency in this service 4	I thought there was too much inconsistency in this service 5 (Strongly agree)
I would imagine that most people would learn to use this service very quickly	I would imagine that most people would learn to use this service very quickly 1 (Strongly disagree)	I would imagine that most people would learn to use this service very quickly 2	I would imagine that most people would learn to use this service very quickly 3	I would imagine that most people would learn to use this service very quickly 4	I would imagine that most people would learn to use this service very quickly 5 (Strongly agree)
I found the service very cumbersome to use	I found the service very cumbersome to use 1 (Strongly disagree)	I found the service very cumbersome to use 2	I found the service very cumbersome to use 3	I found the service very cumbersome to use 4	I found the service very cumbersome to use 5 (Strongly agree)
I felt very confident using this service	I felt very confident using this service 1 (Strongly disagree)	I felt very confident using this service 2	I felt very confident using this service 3	I felt very confident using this service 4	I felt very confident using this service 5 (Strongly agree)
I needed to learn a lot of things before I could get going with this service	I needed to learn a lot of things before I could get going with this service 1 (Strongly disagree)	I needed to learn a lot of things before I could get going with this service 2	I needed to learn a lot of things before I could get going with this service 3	I needed to learn a lot of things before I could get going with this service 4	I needed to learn a lot of things before I could get going with this service 5 (Strongly agree)

Would you be willing to assist us with further user research? If so please leave your email address below. Please note we will not share your details with any other parties.