2014 Children Services Customer Survey

 
We want to know your opinion about our services. Please complete the on-line survey and follow the instructions to submit your answers directly to the Quality Improvement Department. The information you provide is confidential. We appreciate your input.
1. Today's date:
MM DD YYYY
MM/DD/YYYY
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2. Your race/ethnicity:
3. What is your age group?
4. What is your gender?
5. How are you related to the children?
6. Are the children living:
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