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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Did you have a say in choosing the services or programs you receive? Almost Always = 100%	Sometimes = 50%	Almost Never = 0%
Comments:

Center for Family Support Satisfaction Survey

1. I am:

2. I receive services in:

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

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

5. Do you like the services you receive?

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