Name

Email Address

How Would You Rate Aishling Companion Home Care Service? How Would You Rate Aishling Companion Home Care Service? Exceptional Average Poor

Please Explain

Did your ACHC caregiver consistently arrive on time? Did your ACHC caregiver consistently arrive on time? Yes No

If No, Please Explain

Did your caregiver ever call you directly to alert you they may be late? Did your caregiver ever call you directly to alert you they may be late? Yes No

Was your caregiver helpful, courteous and responsive to your needs? Was your caregiver helpful, courteous and responsive to your needs? All of the time Most of the time Rarely

Please Explain

Was your caregiver's appearance clean, neat and professional? Was your caregiver's appearance clean, neat and professional? Always Most of the time Rarely

Did your caregiver use his/her cell phone while on the job? Did your caregiver use his/her cell phone while on the job? Rarely or Never Occasionally Frequently / All of the time

Did your caregiver bring his / her own food? Did your caregiver bring his / her own food? Yes No

Did your caregiver over-share their personal details or troubles or cross the boundaries of being unprofessional? Did your caregiver over-share their personal details or troubles or cross the boundaries of being unprofessional? Yes Occasionally never

Did your caregiver give you your privacy when family or friends came to visit? Did your caregiver give you your privacy when family or friends came to visit? Yes No

Please add a Testimonial of your caregiver