Disaster Relief Shelter Exit Feedback Form
Full Name
Departure Date
How long did you stay at the shelter?
Overall, how satisfied were you with the shelter services?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Were your needs met during your stay?
All needs met
Most needs met
Some needs met
Few needs met
No needs met
What worked well for you during your stay?
What could we improve?
Additional Comments