1. Agency-wide Satisfaction Survey

Please help us serve you better by completing this short survey!

* 1. What programs/services are you involved in at Transitions? (Choose all that apply)

* 2. Please rate the following:

  Poor Fair Good Very Good Excellent
Accessibility, cleanliness, and comfort of facilities
Wait time until first appointment
Helpfulness and friendliness of agency staff members

* 3. Please rate the following:

  Poor Fair Good Very Good Excellent
The degree to which treatment helped you to deal with your problem/complaint
The degree to which services have supported your efforts to become more self-sufficient
Overall quality of care and services

* 4. Please rate your agreement to the statement "I would recommend Transitions of Western Illinois to a friend".

Please finish survey on back of this page

* 5. Please rate your agreement with the statement "I am satisfied with the services that I receive from Transitions of Western Illinois."

* 6. Other Comments/How could Transitions of Western Illinois' services be improved?

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