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Satisfaction with Service Questionnaire : Family Preservation Program 

Please answer the following questions so we can evaluate how well we have responded to your/your family’s needs. Your participation in this survey is voluntary and all of your answers will be anonymous.
For statements 3-15, please choose the most appropriate answer to tell us if you agree or disagree with the statements. For the remaining questions, please write your answers in the space provided.
1.How many sessions with a worker did you/your child have:
2.) I/my child received services in:
3.I participated in my/my child’s treatment.
4.The worker helped me/my child to develop treatment goals that met my/my child’s needs.
5.I/my child felt heard and respected by the worker.
6.The worker identified both strengths and needs in my/our family.
7.Other family members and I were invited to participate in my/my child’s treatment as needed.
8.My/my child’s culture was respected and taken into consideration by the worker.
9.The worker was able to effectively communicate with me/my child in the official language of my/our choosing.
10.NEOFACS staff  communicated well with each other and with and me/my child.
11.I am/my child is more able to manage difficulties than before treatment.
12.The services I/my child received allowed me/my child to meet my goals/my child’s goals.
13.I have/my child has strengthened skills and abilities because of the services provided.
14.I have/my child has less needs and symptoms because of the services provided.
15.I would recommend NEOFACS to other families.
16.Please describe your/your child’s reasons for ending service (check all that apply)
17.What did NEOFACS do well?
18.What change(s) can NEOFACS make that would have the biggest positive impact on the service you/your child received?
19.Additional Comments:
20.Have you had the opportunity to be supported by any NEOFACS volunteers, while receiving a service from us?