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* 1. How long have you known about the organization?:

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* 2. Are you employed by an organization that refers clients to our services?

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* 3. If Yes, Please select the type/focus of your organization that most applies:

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* 4. When contacting us by phone, your call is answered in a prompt and courteous manner.

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* 5. Our employees return phone calls and/or answer email messages in a timely manner.

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* 6. Requests for information about our services, or about an individual receiving services are responded to in a timely.

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* 7. The organization treats all persons participating in services with respect.

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* 8. The organization encourages and is open to feedback about the quality of our services.

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* 9. I would recommend the organization's services to a family member, friend, or client in need.

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* 10. Please provide any specific suggestions you may have for improving the organization and its services

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