∞Inspire Hope-Seek Change-Strengthen Families∞

Question Title

* 1. Name

Question Title

* 2. Date of Birth

Date

Question Title

* 3. Today's Date

Date
This survey allows you to tell us what you think about your Dually Involved Youth experience.  By completing this survey, you will help us improve the Dually Involved Youth initiative.  Under each question check the answer that best matches what you feel about this experience.  Most of the questions allow you to add additional comments if you wish.  Your answers will remain confidential and will not help or hurt your relationship with the Court or with Job & Family Services.   

Question Title

* 4. Are you satisfied with the types of services in your DIY treatment plan? (check one)

Question Title

* 5. Are there services you think you should have gotten but did not? (check one)

Question Title

* 6. Are there services you received you do not think you needed? (check one)

Question Title

* 7. Are you satisfied with the providers who gave you services? (check one)

Question Title

* 8. If you are not satisfied, did you inform your case worker? (check one)

Question Title

* 9. Was there a service provider you liked better than the others? (check one)

Question Title

* 10. Was there a service provider you liked less than the others? (check one)

Question Title

* 11. How satisfied were you with the court proceedings? (check one)

Question Title

* 12. Staff valued me as a person? (check one)

Question Title

* 13. Staff were willing to work with me? (check one)

Question Title

* 14. When decisions about my treatment were made, I felt like I was a partner with staff and that they listened to what I wanted to accomplish. (check one)

Question Title

* 15. When I interacted with staff, they were professional, polite, and respectful. (check one)

Question Title

* 16. Is there anything else you want to tell us about your experience with the DIY program?

 

Thank you for completing the survey.  Your thoughts will help us improve this initiative.

 

 

 
In partnership between:
Clark County Domestic Relations Court-Juvenile Section ~ Clark County Department of Job and Family Services

T