Exit this survey 2-1-1 Service Provider Survey 1. Default Section Question Title * 1. Please Select the county or counties your organization serves. Clark Champaign Madison Question Title * 2. Please select the field that best describes your organization. Non Profit Government Faith Based Health Related Business/Professional Other (please specify) Question Title * 3. Have you received client referrals provided by Information & Referral/2-1-1? Yes No Don't Know Question Title * 4. If you received client referrals, did Information & Referral/2-1-1: Yes No Neutral N/A Refer clients appropriately to your agency? Refer clients appropriately to your agency? Yes Refer clients appropriately to your agency? No Refer clients appropriately to your agency? Neutral Refer clients appropriately to your agency? N/A Provide correct information to clients about your agency? Provide correct information to clients about your agency? Yes Provide correct information to clients about your agency? No Provide correct information to clients about your agency? Neutral Provide correct information to clients about your agency? N/A Update your agency info in their database accurately? Update your agency info in their database accurately? Yes Update your agency info in their database accurately? No Update your agency info in their database accurately? Neutral Update your agency info in their database accurately? N/A Question Title * 5. Please evaluate your experience when using Information & Referral/2-1-1 services. Yes No Neutral N/A Did the staff treat you in a courteous manner? Did the staff treat you in a courteous manner? Yes Did the staff treat you in a courteous manner? No Did the staff treat you in a courteous manner? Neutral Did the staff treat you in a courteous manner? N/A Would you use the service again? Would you use the service again? Yes Would you use the service again? No Would you use the service again? Neutral Would you use the service again? N/A Did you receive accurate information? Did you receive accurate information? Yes Did you receive accurate information? No Did you receive accurate information? Neutral Did you receive accurate information? N/A Did you receive helpful information? Did you receive helpful information? Yes Did you receive helpful information? No Did you receive helpful information? Neutral Did you receive helpful information? N/A Would you recommend the service to others? Would you recommend the service to others? Yes Would you recommend the service to others? No Would you recommend the service to others? Neutral Would you recommend the service to others? N/A Question Title * 6. If you would like to schedule a presentation or request 2-1-1 brochures or resource lists, please call 2-1-1 or 323-1400, 653-4634, 740.852-0267 or 855-868-9088 Thank you for completing this survey! Done