General Satisfaction Survey

Thank you for taking a moment to tell us how we are doing and support us in constantly working to improve the quality of the services and supports we deliver to you!


* 1. Who are you? (Please choose one)

* 2. Name of staff person you were working with:

* 3. What is your level of satisfaction with the following:

  Very Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied
Time of response
Answer to need/question
Employee's interaction

* 4. What works well about the things we are doing right now?

* 5. What can we do better?

* 6. If you would like someone to follow up with you because you are dissatisfied with your interaction with our agency, please provide your contact information in the box below (optional).

Thank you for completing this brief survey about your interaction with the Coshocton County Board of DD. Your feedback helps improve our supports and our staff.

Please feel free to fill a new survey out each time you have a new interaction with any of our staff.

If you feel you have a formal complaint involving programs, services, policies or administrative practices of the Board or any entities acting under contract with the Board, please find additional information here: