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* 1. I was helped in a timely manner

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* 2. I was treated with respect

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* 3. I got the information/services I needed

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* 4. I was informed of other CASOKY or community services

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* 5. I would recommend CAOKY to friends and/or family

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* 6. I would be willing to participate in a discussion group to help CASOKY continue to improve

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* 7. When I came into the building, I felt welcomed

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* 8. The building was clean

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* 9. Please circle the county you live

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* 10. Circle the program in which you were receiving services

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* 11. Name and contact if you would like to be contacted for  discussion

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* 12. Comments

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