Voices For Independence Consumer Satisfaction Survey 2009-2010

1. Voices For Independence Consumer Satisfaction Survey 2009-20010

1. Please click the services you are currently receiving or participating in?

Please click the services you are currently receiving or participating in? Deaf and Hard of Hearing Services

Attendant Care

Skills Training

Nursing Home Transition

RAP Group

Housing

Peer Support

Advocacy

YAPS

2. Do you feel actively involved in making decisions concerning your services?

Do you feel actively involved in making decisions concerning your services? ALWAYS

ALMOST ALWAYS

SOMETIMES

NEVER

If you indicated sometimes, never or if you would like to be more involved please explain

3. Do the services you receive provide you with the support you need to achieve your goals?

Do the services you receive provide you with the support you need to achieve your goals? ALWAYS

ALMOST ALWAYS

SOMETIMES

NEVER

If your services do not support your goals please explain and/or tell us how you think VFI could do things differently to assist you

4. Does the staff in the office treat you with courtesy and respect?

Does the staff in the office treat you with courtesy and respect? ALWAYS

ALMOST ALWAYS

SOMETIMES

NEVER

Please comment if you desire

5. Does your IL Specialist, Service Coordinator and/or other office staff respond appropriately if you bring a concern to their attention?

Does your IL Specialist, Service Coordinator and/or other office staff respond appropriately if you bring a concern to their attention? ALWAYS

ALMOST ALWAYS

SOMETIMES

NEVER

If possible, please expand on your difficulties or concerns

6. What services, if any, would you like to see Voices For Independence provide in the future?

What services, if any, would you like to see Voices For Independence provide in the future?

7. Please write any additional comments you care to give.

Please write any additional comments you care to give.

8. If you would like a call to address any concerns or suggestions, please include your name and phone number. THANK YOU FOR HELPING US PROVIDE BETTER SERVICES!!!!

If you would like a call to address any concerns or suggestions, please include your name and phone number. THANK YOU FOR HELPING US PROVIDE BETTER SERVICES!!!!

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