Social Services would love to hear your opinion!

This survey is anonymous and your answers will not impact your services. 

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* 1. Today's Date (MM/DD/YYYY):

Date

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* 2. Please click yes or no for each of the following:

  Yes No
I feel I have control over my life.
I achieved my desired outcomes (goals).
Are you getting the services you need?
Is it easy to reach your service coordinator?
Are you happy with your services?
Is your service coordinator respectful of your cultural/ethnic background?

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* 3. What do you like best about your services?

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* 4. How can we make our services better?

You don't have to answer, but it would help us to know:

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* 5. What is your gender?

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* 6. What is your age?

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* 7. What is your race/ethnicity/culture (check all that apply):

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* 8. If you would like a response, please provide your name and contact information. We will respond within 10 business days.

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