Client Satisfaction Survey

How would you rate our reliability of services

Extremely reliable

Somewhat reliable

Not reliable

How would you rate our agency responsiveness when you have needed us?

Extremely responsive to your needs

Somewhat responsive to your needs

Not responsive to your needs

Have you been treated with courtesy when interacting with the agency staff?

Always

Sometimes

Never

Do you have any concerns with the agency policy on your secured records in this agency?

Never

Sometimes

Always

If you could change anything with the agency settings what would that be?

What have you seen as helpful regarding the staff at the agency?

Have you ever experienced a negative interaction with our staff? Please explain.

Do you feel the staff working with you are knowledgable regarding your case and your goals?

Extremely

Somewhat

Not at all

Have you had any concerns with the agency cost of services?

Yes

No

Insurance covers service

Do you feel you have proper accessibility of services at the agency or in your home?

Always

Sometimes

Never