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We are interested in your family’s experience at Five Counties Children’s Centre. For each question, please choose ONE answer that you feel best fits your experience.  In particular, we would like to know about your perception of the service you and your family has been receiving from our Centre.

By completing this brief questionnaire you can help us to improve our services. All your responses are kept confidential and will not affect the services that you receive at the Centre.

Results of the survey and action taken as a result of this survey will be posted on the Five Counties Children’s Centre website (www.fivecounties.on.ca).

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* 1. My child receives services for:

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* 2. We receive our services

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* 3. My child and I feel welcomed, respected, and valued at Five Counties.

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* 4. Five Counties provides me with the information and skills needed to help my child with their therapy.

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* 5. Five Counties helps me achieve the goals I have for my child.

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* 6. I am able to get service in a way that is helpful (in person, virtual, home activities, consultation, etc.)

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* 7. I would recommend Five Counties to family and friends.

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* 8. We are always trying to improve our services. Please tell us what you would like to see Five Counties do in the future.

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* 9. Would you be interested in purchasing more/other services from Five Counties?

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* 10. If YES which services would you like to purchase?

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* 11. Optional: Please provide your Name and Contact information

0 of 11 answered
 

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