Feedback

Give feedback about your experience hiring a Tramper to help us evaluate the scheme.

We hope you have enjoyed your visit and enjoyed hiring the Tramper scooter.

We would be very grateful if you would complete this feedback form as it will help us evaluate the scheme.

Please let us know if you have experienced any problems or difficulties with the Tramper scooter during your visit or if there was anything we could have done differently.

If you would like to discuss this with us, please contact us

Feedback

First Name

Last Name

Phone

Date Of Visit

Site Visited

How Many Individuals Were In Your Party

Tick one box in response to each heading

Future Use: How likely is it that...

If unlikely, why?

How could we improve the scheme?

Please tell us about your mobility for our records.

Do you consider yourself to have a permanent mobility difficulty?

Do you consider yourself to have a temporary mobility difficulty?

Do you consider yourself to have a disability?

Do you hold a current blue badge?

Please tell us what you enjoyed about the Tramper?

Equal Opportunities

Responses to this section of the form are optional, but by taking time to answer these questions you will be helping us to provide valuable information when we apply for future funding to continue this service. Summary of this information will help to show that LDM is endeavouring to be as inclusive as possible to provide a service to the whole community.

To ensure this policy is working, we monitor equality and diversity information. This personal information is confidential and will be held securely to meet the requirements of the Data Protection Act and it will not be given to any other organisations.

Please answer as many questions as you are comfortable with by ticking one answer for each question:

To which gender identity do you most identify?

Male

Female

Prefer Not to Answer

Other: please specify

My ethnicity:

Mixed

White & Black Caribbean

White & Asian

White & Black African

Other

Black/African/Caribbean/Black British

African

Caribbean

Black British

Other

Arab

English

Prefer Not To Say

Other: please specify

I have read and understood Outdoor Mobility's Privacy Notice

Please email me with updates about Outdoor Mobility

Thank you for helping us by giving your feedback.