Center for Family Support Satisfaction Survey

The Center for Family Support is committed to providing supports to individuals with disabilities and to the family members who care for them. It is our mission to provide quality services so that individuals can live the lives they want.

We are trying to find out if you like our services and if they are helping you. We will use this information to improve our programs. Your answers will be kept confidential.

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* 1. I am:

An individual receiving services

A family member/advocate

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* 2. I receive services in:

New York

New Jersey

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* 3. The services I get from Center for Family Support include (check all that apply):

Residential

Day Program

Medicaid Service Co-ordination

At-Home Residential Habilitation

Respite

Home Care

TBI Services

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* 4. If receiving TBI Services, please check types of service received.

ILST

IBP

CIC

Service Coordination

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* 5. Do you like the services you receive?

Almost Always = 100%

Sometimes = 50%

Almost Never = 0%

Comments:

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* 6. Did you have a say in choosing the services or programs you receive?

Almost Always = 100%

Sometimes = 50%

Almost Never = 0%

Comments: