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Annual Survey of Individual Satisfaction 2026

1.Your Name (Optional):
2.Service (s) you receive from Assisted Independence, LLC.:
3.Name of Direct Support Professional(s) (DSP), Manager of Direct Supports, and/or Recreational Therapist from Assisted Independence, LLC.:
4.How would you describe your overall satisfaction with the service(s) you receive from Assisted Independence, LLC.? Choose the answer that best describes your overall satisfaction.
5.How satisfied are you with the way our services help you reach your individualized goals? Choose the answer that best describes your satisfaction.
6.How satisfied are you with your DSP(s) or Recreational Therapist personalization of services? For example, are services tailored to your preferences and abilities? Choose the answer that best describes your satisfaction.
7.How satisfied are you with your DSP(s) or Recreational Therapist scheduling and punctuality? Choose answer that best describes your satisfaction.
8.How satisfied are you with the Fun Guide activities we provide? Choose the answer that best describes your satisfaction.
9.Do you feel safe when receiving care from your DSP(s) or Recreational Therapist? Choose the answer that best describes your feeling.
10.Does your DSP(s) or Recreational Therapist communicate clearly and respectfully with you? Choose the answer that best describes your satisfaction
11.How satisfied are you with communication and responsiveness from the Manager of Direct Supports? (This does not apply to those only receiving Recreational Therapy). Choose the answer that best describes your satisfaction.
12.Are there additional services you wish were available through Assisted Independence, LLC.? If so, what services:
13.Would you recommend Assisted Independence, LLC. to others? Choose the option that best describes your answer.
14.Additional comments, suggestions, or concerns: