Describe your agency and review goals. Makeform creates a survey where clients and families rate caregiver reliability, communication, respect, and service quality, then request follow-up.
Send responses to Slack, Google Sheets, and Zapier.
Sample prompts for the builder
Choose a starting point, adapt it, or send the prompt into the Makeform builder. Each example shows a practical survey structure.
Audience
Clients receiving recurring in-home support
Format
Short mobile survey with rating scales
Prompt size
320 chars
Example form structure
Short mobile survey with rating scales
Which service period are you reviewing?
How reliable were scheduled visits?
Were agreed tasks completed?
What could we improve?
Would you like a coordinator to contact you?
Suggested routing tags
Positive feedback
Follow-up requested
Service concern
Ask who is responding and which service period they are reviewing so each score has useful context.
Step 1
Ask
send after a visit, milestone, or service period
Step 2
Listen
capture ratings, context, and client comments
Step 3
Route
send requested follow-ups to the right coordinator
Step 4
Improve
review themes by caregiver, branch, or service
Feedback that leads somewhere
A single score cannot identify whether punctuality, communication, continuity, or expectations need attention. A structured form separates those moments.
Use consistent scales for reliability, communication, respect, and task completion across service periods.
Show a comment box after low ratings and invite positive examples so scores retain context.
Let respondents request contact and choose a preferred method or time for coordinator follow-up.
Use the right moment
Keep core service-quality questions, then tailor prompts to the feedback moment.
Check whether schedules, introductions, and contact instructions matched onboarding expectations.
Ask about updates, continuity, responsiveness, and the client's preferences.
Confirm that a schedule, caregiver, or task change was clear and works for the respondent.
Review the experience, collect ideas, and ask whether the respondent would recommend the agency.
Survey workflow
Turn the service moments you need to understand into a short survey for any device.
Identify the respondent and whether the survey follows onboarding, a monthly review, a service change, or closeout.
Keep scales consistent and remove questions you cannot act on. Add identifiers only when they help route responses.
Send the public link by email or text, place it in a portal, or display a QR code. No respondent account is needed.
Notify a coordinator about follow-up requests and send submissions to connected workflows for review by service, team, or period.
Better than an unstructured check-in
A repeatable survey helps an agency hear beyond the people who call the office.
Field guide
Use six sections to identify the experience, measure service, and manage follow-up.
Respondent context
Clients and family members observe different parts of service. Ask their role, then show relevant questions.
Service reference
Context makes scores easier to interpret. Collect only the identifiers needed to route the response.
Core rating scales
Use consistent scale labels. Separate operational reliability from interpersonal experience.
Conditional detail
Use conditional logic to request context after low scores without lengthening every response.
Open feedback
Open questions reveal what clients and families noticed. Ask about strengths and changes.
Follow-up preference
Ask whether contact is wanted, then collect preferences only when follow-up is selected.
Related tools
Create broader satisfaction checks, anonymous channels, and complaint forms.
Survey clients across services, locations, or stages.
Open toolCollect feedback about communication and service experiences.
Open toolBuild satisfaction surveys with consistent scales.
Open toolFAQ
Practical answers for agencies designing a client and family feedback process.
It is a survey for clients, relatives, or representatives to review home care services. It measures caregiver reliability, communication, respect, agreed tasks, scheduling, and overall quality, with space for comments and follow-up requests.
Ask who is responding and which period they are reviewing. Rate punctuality, scheduling, responsiveness, caregiver consistency, respect, and task completion. Finish with what worked, what should change, and whether contact is wanted.
They can share core questions, then branch by role. Clients can rate comfort, listening, and visits; family members can rate updates, coordination, and responsiveness. Ask the respondent's role first.
Use focused ratings and one or two open questions for recurring check-ins. Milestone surveys can be longer. Remove questions the agency will not use and show extra comment prompts only when relevant.
Yes. Omit required identity fields or offer identified and anonymous paths. Explain that follow-up needs contact details, and do not promise anonymity if other required answers reveal the respondent.
Ask for context after low scores and whether coordinator contact is wanted. Notifications can route the submission. The agency should define who reviews responses and owns the next step.
Yes. Makeform is unlimited free for generating, editing, publishing, and collecting responses. The paid tier only removes the Makeform badge. Adjust every question, then share the form by link or embed.
Responses arrive in the Makeform inbox and can connect to Google Sheets, Slack, or Zapier. Add service, branch, or period fields when needed for sorting, and manage access under agency policies.
Make every check-in easier to act on.
