Thank you for filling out this confidential survey. Your comments and suggestions are important to us!

Question Title

* 1. Quality Indicator

  Strongly Agree Agree Disagree Strongly Disagree Not Applicable
My questions regarding the enrollment process were answered effectively.
My calls or emails are responded to in a timely manner.
My questions were answered effectively.
The CSHCS team responded to my family's needs. 
The facility was accessible/reasonable accommodations were provided. 
I am aware the CSHCS program may cover some prescriptions. 
The CSHCS team offered me referrals/resources at LCHD or in the community.
The referrals/resources I received were easy to understand.
The referrals/resources were appropriate to my family's needs.
I have met with the nurse to develop a plan of care for my child(ren).
I have a better understanding of the CSHCS program after our plan of care meeting.
The plan of care and information provided was useful.
I have discussed transition to adulthood for my child with the nurse.
Staff were willing to accommodate my cultural and ethnic needs.
Staff treated me with respect.
I am aware of the other services available to me at the LCHD.
I would recommend the LCHD to others. 

Question Title

* 2. Additional Information

  Yes No Not Applicable
Have you ever called the CSHCS Family Phone LIne (1-800-359-3722)?
Is your child 13 years of age or older?
Are you aware that CSHCS eligibility ends at age 21 for most clients?

Question Title

* 3. If you have any comments or disagree with any of these, please explain. 

Question Title

* 4. Would you like to be contacted? If yes, please provide your contact information:

T