* 1. Overall, I have been satisfied with my experience(s) with Nodin Child & Family Intervention Services.

* 2. I am treated with respect and feel accepted.

* 3. The employee listened carefully to me.

* 4. I feel my counselor helped me move in a positive direction.

* 5. My counselling session(s) help me to deal more effectively with my issues.

* 6. I was able to make decisions from the help I received.

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

* 8. If you would like us to contact you, please fill out the information below.