ISS/PS Satisfaction Survey Question Title * 1. Participant information: Name * Email Address Phone Number Question Title * 2. What type of ISS or PS services are you receiving? In-home supports Assistance with errands Assistance with medical appointments Community integration PALS program Other (please specify) Question Title * 3. How many hours or days of service are you receiving per week? Question Title * 4. Is there a weekly set schedule for services? Yes No Question Title * 5. When did you last receive ISS/PS services? Date / Time Date Time AM/PM - AM PM Question Title * 6. Please describe the type of services you last received (Please be specific). Question Title * 7. Are you satisfied with your ISS/PS program? Yes No Question Title * 8. Do you wish to make any changes to your current ISS/PS program at this time? Yes No If yes, please specify: Question Title * 9. Do you have any other comments or concerns about your ISS/PS program? Question Title * 10. Do you have any ideas or recommendations to improve our ISS/PS services? Done