Libraries Form - Tell Us What You Think

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	What Matters to You
	Tell Us What You Think

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Are you happy with your library service?
We are really interested in your views - why not help us to plan future improvements to your library service?

Library or mobile stop name

	It would help us if you put your library membership number (on your card) below

Q1	If you wish to make any comments about this library service please do so in the space below

Q2	It would be helpful if you would spare a moment to tell us what you think of the following:
Q2		Very good	Good	Adequate	Poor	Very poor	N/A
	Staff helpfulness
	Opening hours
	Choice of books
	Choice of music CDs
	Choice of DVDs
	Choice of talking books
	Information service
	Events/activities
	Provision of seating and tables
	Attractiveness of library: inside
	Attractiveness of library: outside
	The service overall

We understand that you may want to keep the following information private and not share it with us. However, if you do answer the following questions we will use it to help provide you with support and improve services and facilities for specific groups.

What is your postcode?

Are you:

Male

Female

The Disabilty Discrimination Act (1995) defines a person as disabled if they have a physical or mental impairment which has a substantial and long term adverse effect on their ability to carry out normal day to day activities.

Do you consider yourself to be a disabled person?

Yes

If yes, please tick types of impairment/s which apply to you:

Physical

Visual

Hearing

Mental health condition

Learning disability

Health condition, such as cancer, HIV or MS

Thank you for taking the time to complete this questionnaire. It will help us to plan future improvements to the library service.

If you would like a reply to any specific comment, please fill in your contact details and tell us your preferred method of response:

Mr/Mrs/Miss/Ms/Other

Surname

First Name

Address

	Email
	Please only provide if you are happy to receive emails

Telephone

Mobile

Which is your preferred method of response?

Telephone

Email

Post

Internet

Text

Your details will not be disclosed to any organisation not associated with LCC except where law requires us to release that information. The information will be removed from our database when you request it.

If you do not want us to use your information for direct marketing purposes, please tick this box

We would like to share your information with other areas of LCC, if you prefer we do not pass on this information, please tick this box

Please let us know at any time if you want to stop receiving information from us.

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Last Updated: 7 October 2008

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