Family Feedback Form

We welcome all feedback as an opportunity for improvement.

Family Feedback Form

Who is completing this form?*
- Operations
- Parent/s
Your Name*
Full Name
Name of Family Member*
Full Name
Do you feel Leor is meeting your expectations?*
- Yes
- No
Please let us know how we can improve our services.*
Do you feel any of our policies and procedures need updating?*
- Yes
- No
Please share any suggestions you may have.
Are there any service issues?*
- Yes
- No
What could be improved?
Has there been any changes/or will there be any changes to your family home environment that we need to be aware of?*
- Yes
- No
Please outline the changes in your home environment.*
Do you have any updated or new management plans for your child/ren (e.g. allergy plan, anaphylaxis plan, asthma plan etc.)?*
- Yes
- No
Please select the type of management plan/s.*
- Allergy Action Plan
- Anaphylaxis Action Plan
- Asthma Action Plan
- Behaviour Support Plan
- Bowel Care Plan
- Catheter Care Plan
- Diabetes Management Plan
- Epilepsy Management Plan
- Manual Handling Plan
- Mealtime Management Plan
- Medication Authority Form
- PEG Feeding Plan
- Seizure Management Plan
- Swallowing and Nutritional Checklist
- Other
Other management plan for the child:*
Please upload any new management plans for your child/ren.*
Drop files here or

Max. file size: 128 MB, Max. files: 5.
How likely are you to recommend Leor?*
1 2 3 4 5 6 7 8 9 10
Do you have additional comment/s?*
- Yes
- No
Additional Comments*
Would you like to request a phone meeting with Management to discuss any issues or Lead Educator to discuss any developmental concerns?*
- Yes
- No
Please let us know a suitable time or day to talk.*

Phone: 02 9051 0511
Email: learn@leor.com.au