This free survey is powered by QUESTIONPRO.COM
  1. Surveys
  2. 2013
  3. March
  4. F
  5. FY2013 SHIP
0%
 
 
What Agency provides your SHIP counseling?
 
Highlands
 
Jewish
 
Metro Parks
 
MPCAA Bullitt
 
MPCAA Shelby
 
TCCAA Henry
 
TCCAA Trimble
 
TCCAA Oldham
 
 
 
Age
 
Under 20
 
20-29
 
30-39
 
40-49
 
50-59
 
60-69
 
70-79
 
80-89
 
90 and Over
 
 
 
Gender
 
Female
 
Male
 
 
 
Assistance requested by:
 
Self
 
Couple
 
Caregiver
 
Professional
 
Other
 
 
 
 
How did you learn about SHIP?
 
Medicare
 
Media
 
Friend/Relative
 
Agency
 
Presentation/Health Fair
 
Other
 
 
 
 
Name of the SHIP counselor who assisted you:
   
 
 
 
Were you able to recieve assistance at the time of your call or did you leave a message?
 
My question was answered when I called
 
I had to leave a message
 
 
 
If a message was left, how long was it until your call was returned?
 
Same day
 
Next day
 
Same week
 
More than one week
 
Never returned
 
I don't remember
 
 
How would you rate...
Excellent Good Fair Poor
The availability of the SHIP counseling service
The counselor's ability to identify your issues and provide you info and assistance
The counselor's friendliness, courtesy and patience
The counselor's abilty to convey the information clearly
The usefulness of the information provided
 
 
 
Based on your experiences, would you refer others to SHIP counseling or use the services again yourself?
 
Yes
 
No
 
Not Sure
 
 
 
Do you need additional information about the topic you discussed on your call and/or other information? If so, please put your name and phone number below and indicate the best time of day to reach you.
   
 
 
 
Additional Comments
   
 
Please contact [email protected] if you have any questions regarding this survey.
Survey Software Powered by QuestionPro Survey Software