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Enrollee Services

 

1. I am satisfied with the services I receive.

I am satisfied with the services I receive.   Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Comments

2. My needs are addressed promptly.

My needs are addressed promptly.   Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Comments

3. Staff treats me and my family with kindness and respect.

Staff treats me and my family with kindness and respect.   Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Comments

4. The goals and activities in "My Plan" are what I want and are important to me.

The goals and activities in "My Plan" are what I want and are important to me.   Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Comments

5. I received information about the services available to me.

I received information about the services available to me.   Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Comments

6. Additional Comments (Likes/Dislikes):

Additional Comments (Likes/Dislikes):

7. Name (optional)

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