Client Satisfaction Survey

Thank you for taking the time to tell us about your experience. We appreciate your feedback on how satisfied or unsatisfied you are with the services that you are receiving. Your responses will be confidential and will never affect the service that you receive at this agency. However, the feedback that we get from clients like you will help us identify strengths and weaknesses and make improvements.


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* 1. Overall, how satisfied are you with the assistance you have received from this agency?

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* 2. Overall, how would you rate the service you received from the staff at our office?

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* 3. How long have you been receiving assistance from
this agency?

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* 4. Has this program been helpful in referring you to medical care, insurance coverage, and other services you need?

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* 5. How satisfied are you with your case management services?

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* 6. Does your case manager respond in a timely manner?

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* 7. Is your case manager knowledgeable about resources in the community?

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* 8. Does your case manager address the concerns that you raise when you meet?

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* 9. Overall, how helpful is the as´╗┐sistance that you receive from your case manager

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* 10. What did/do you like most about this program/agency?

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* 11. What do you think we can do to make the program/agency better?

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* 12. Do you have any other comments, questions, or concerns?

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* 13. Age

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* 14. Gender

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* 15. Race/Ethnicity

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