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Surveys
2015
February
F
FY2015 SHIP
FY2015 SHIP
SHIP Client Satisfaction Survey
0%
What Agency provides your SHIP counseling?
Highlands
JFCS
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 receive 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.
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