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HCBS Resident Survey |
Welcome!
Thank you very much for cooperating with this survey request!
This survey will ask you some questions about where you live, and about your experience living there. You will first be asked to provide some identifying information about who your mental health and/or addiction service provider is, and the address where you live. You won’t need to tell us your name at any point in this survey.
The survey questions can be answered by clicking the circle next to the most accurate answer. Most of the questions can be answered “yes” or “no”, or by selecting about how often you experience something where you live. The last question is a chance for you to tell us about anything we may not have asked about.
You can complete and submit this survey on-line, or if you prefer, your case manager can help you print a copy and you can fill it out on paper. Also, your case manager or the staff where you live can help answer any questions you may have while completing this survey.
Thanks again for helping us learn more about your home!
This survey will ask you some questions about where you live, and about your experience living there. You will first be asked to provide some identifying information about who your mental health and/or addiction service provider is, and the address where you live. You won’t need to tell us your name at any point in this survey.
The survey questions can be answered by clicking the circle next to the most accurate answer. Most of the questions can be answered “yes” or “no”, or by selecting about how often you experience something where you live. The last question is a chance for you to tell us about anything we may not have asked about.
You can complete and submit this survey on-line, or if you prefer, your case manager can help you print a copy and you can fill it out on paper. Also, your case manager or the staff where you live can help answer any questions you may have while completing this survey.
Thanks again for helping us learn more about your home!