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We know that the process of talking with outsiders about your life, hopes and challenges can be both difficult and stressful. Please take a few moments to share your opinions regarding your experience with us. Your feelings, whether positive or negative, matter to our agency. Please know that your feedback will help us better serve your family and others in the future. Thank you for participating in our survey. 
1.What is your name?(Required.)
2.What county did you (client/family) live in when you were receiving services from Family Ties Inc.?(Required.)
3.Please indicate which worker asked you to complete this survey?(Required.)
4.What is the name of the worker that asked you to complete this survey?(Required.)
5.What type of services did you, your child or your family receive? Select all applicable services.(Required.)
6.Tell us a little bit about your services?(Required.)
7.Are you the client?(Required.)
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