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)