Easterseals Satisfaction Survey- Ongoing

Easterseals Iowa believes in obtaining regular input from those that we connect with, so we are able to continually strive to be the best advocate for people with disabilities, their families, and the community. We believe that your ideas and suggestions are vital to achieving this goal.

Thank you for taking the time to complete the following survey regarding your experience with Easterseals Iowa.

If you have an immediate need, please contact Katie Peck, Director, Customer Care & Compliance at KPeck@eastersealsia.org or 515-309-2618 to assist with resolution.

Question Title

* 1. Feedback provided for:

Non-Program Related Feedback

AIM

Adult Day Programming (CSI or Life Club)

Assistive Technology Programming

Case Management

Child Development Center

Crisis Stabilization Supports

Daily Supported Community Living

Child Development Center

Employment & Education Programming

Daily Supported Community Living

Host Home Programming

Hourly Supported Community Living

MST - Multi-Systemic Therapy

Respite

Rural Solutions

Summer Camp

Question Title

* 2. Respondent Role

Program Participant

Parent/Guardian/Family Member

Case Manager

Community Provider

Community Member

Event Space Rental Customer

Donor

Volunteer

Question Title

* 3. Satisfaction with Easterseals interactions and/or services

Very Dissatisfied

Dissatisfied

Neutral

Satisfied

Very Satisfied

Comments

Question Title

* 4. How likely are you to recommend Easterseals to someone else?

Very unlikely

Unlikely

Neutral

Likely

Very likely

Comments

Question Title

* 5. Additional Comments:

Question Title

* 6. (Optional) If you'd like to discuss your Easterseals Iowa experience further with Director, Customer Care & Compliance, please include your name and phone number.

Name

Phone Number

Question Title

* 7. (Optional) If you'd like to learn more about Easterseals services & receive our monthly newsletter, please include your email address or visit our website.

Email Address