RSF feedback form

This form is to be completed by the recipient of the award for the experience.

Thank you for taking the time to complete this form. Your feedback helps the Ruth Strauss Foundation understand the impact of the gift and aids in the development of our services and offerings. The information shared will be shared with the Ruth Strauss Foundation and used in reports, publications etc see the privacy notice from the Ruth Strauss Foundation.

The Ruth Strauss Foundation is delighted to be working with Something to Look Forward To so that together we can support families where a parent has incurable cancer to make memories together through special experiences. This project has been developed and funded by the Ruth Strauss Foundation and we are grateful to Something To Look Forward To who are hosting and administering this pilot.




  • About the referrer/nominator:

  • DD slash MM slash YYYY
  • DD slash MM slash YYYY



  • With the following statements about the experience, please score on a scale of 1-10 how much you agree with each one. The scale is from 1 ‘not at all’ to 10 ‘completely’

  • (1 not at all, 10 completely)
    12345678910
  • (1 not at all, 10 completely)
    12345678910
  • (1 not at all, 10 completely)
    12345678910
  • (1 not at all, 10 completely)
    12345678910
  • If answered 'No' and you would like support from the Ruth Strauss Foundation Family Support Service please visit click here and complete our short form. We will be in touch with you shortly. If you have already been in touch with us and would like to debrief or discuss anything further, please contact us at familysupport@ruthstraussfoundation.com
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    • Please tick this box ☐and print your name on this form to show you are happy to give permission for your story to be used by The Ruth Strauss Foundation for the purposes outlined above. Your story will not be republished or used for the charitable purposes you have permitted for any longer than 5 years from your original permission and will remain on our website and social media channels indefinitely. If you change your mind at any time, we will be happy to remove any current stories or references on your request (please note that web archives cannot be amended).
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