Please indicate your affiliation with Capitol Care:

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* 1. Please indicate your affiliation with Capitol Care:

Please check the program(s) provided by Capitol Care that you are involved with:

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* 2. Please check the program(s) provided by Capitol Care that you are involved with:

Do you feel our staff conduct themselves in a professional manner?

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* 3. Do you feel our staff conduct themselves in a professional manner?

Are you satisfied or dissatisfied with Capitol Care's facilities?

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* 4. Are you satisfied or dissatisfied with Capitol Care's facilities?

When you contact the Agency, are you clearly directed to the person with whom you need to speak to either by automatic prompts or by front desk personnel?

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* 5. When you contact the Agency, are you clearly directed to the person with whom you need to speak to either by automatic prompts or by front desk personnel?

When you contact the Agency, is your call responded to appropriately and within a timely fashion?

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* 6. When you contact the Agency, is your call responded to appropriately and within a timely fashion?

Do our transportation services meet your needs?

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* 7. Do our transportation services meet your needs?

When you made a referral to our Agency services, were you satisfied with our intake process?

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* 8. When you made a referral to our Agency services, were you satisfied with our intake process?

Do you have any further recommendations for our agency?

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* 9. Do you have any further recommendations for our agency?

Do you feel Capitol Care values Cultural Diversity?

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* 10. Do you feel Capitol Care values Cultural Diversity?

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