Survey

Please help us to improve our agency by answering some questions about the services you received. Your answers are confidential and will not negatively affect future service. Thank you in advance for your input. It’s greatly appreciated!

Please Select One:

Name

Completely optional, but very helpful. Always confidential.

District Office (if you're a social worker)

Overall, I am satisfied with the services received

My needs and preferences are met by this agency

My child's needs and preferences are met by this agency

My transportation needs are fully met by this agency

Communication with agency staff is adequate

Services are available at times that are convenient

Agency staff are professional and respectful

Agency staff respect my child's and my own spiritual and religious beliefs

Agency staff are flexible and willing to modify services

Agency staff are culturally sensitive

Agency staff are friendly and helpful

What has been your most positive experience in the last 6 months?

What can we do to improve services?

How long have you received agency services?

I am currently receiving services from this agency

Please feel free to add anything else you'd like to say