Social Services would love to hear your opinion!

Filling out this survey will not affect the services you get. 

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* 1. Today's Date (MM/DD/YYYY)

Date

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* 2. Please mark your answer about the service you received:

  Yes No Doesn't Apply to Me
I believe I am safer in my home because of the services I get from VDC.
I believe I am more independent because of the services I get from VDC.
I believe I am healthier because of the services I get from VDC.
VDC services have helped me make the most of my personal money and resources.
I feel less lonely and/or isolated as a result of the services or information I got.
The person I worked with spent enough time with me to understand what I needed.
The person who worked with me treated me with respect.
The person who worked with me answered my questions.
I am satisfied with the service I received.
The person who helped me was sensitive to my cultural/ethnic background.
The meeting place was easy to get to.
The meeting place was comfortable.
I will recommend this service to others.

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* 3. What did you like best about the services you received?

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* 4. How can we make our services better?

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* 5. Does your household have any unmet needs? If yes, please tell us about those below.

You don't have to answer, but it would help us to know:

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* 6. How do you identify your gender?

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* 7. Age

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* 8. Race/Ethnicity/Culture (Check all that apply):

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* 9. Would you like to talk with a staff member about your feedback? If so, give us your name and contact information. We will get back to you within 10 business days.

Thank you for your valuable time and input. Your opinion and feedback will help make sure that we provide the highest quality services to our community!

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