* 1. I was helped in a timely manner.

* 2. I was treated with respect.

* 3. I got the information/services I needed.

* 4. I was informed of other CASOKY or community services.

* 5. I would recommend CASOKY to friends and/or family.

* 6. I would be willing to participate in a discussion group to help CASOKY continue to improve (please provide name and contact number below).

* 7. When I came into the building, I felt welcomed.

* 8. The building was clean.

* 10. Please select the program for which you are seeking services:

* 11. Name and Contact Number:


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