FY25 ADRC Client Satisfaction Survey
KIPDA strives to ensure that we are providing quality resources and assistance to the community. We want your input about your experience with the Aging & Disability Resource Center (ADRC). Thank you!
1.
What is your age?
Under 17 years old
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65-74 years old
75 years or older
2.
What is your gender?
Female
Male
Other
3.
Which race/ethnicity best describes you? (Please choose only one.)
American Indian or Alaskan Native
Asian / Pacific Islander
Black or African American
Hispanic
White / Caucasian
Other (please specify)
4.
How did you first hear about the Aging & Disability Resource Center?
Friend, Neighbor, Relative
Physician or Hospital
Home Health Agency
Newspaper/ Newsletter
Radio
Resource Fair/ Community Event
Website
Brochure, Flyer, Business Card
Other (please specify)
5.
How long did you wait to have a call back from an ADRC specialist?
Same day
Next day
3-5 days
Longer than 5 days
6.
What was the main reason you contacted the ADRC?
Family Caregiver services
In-home services
Transportation
Meals
Medicare Benefits (SHIP)
Housing Options
Medicaid Waiver Services
Community Resources
Other (please specify)
7.
Do you feel the ADRC Specialist you spoke with...
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Listened carefully to what you wanted?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Understood what you wanted?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Explained things to you in a way that you can understand?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Was knowledgeable about the services and information you asked about?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Was courteous and respectful?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
8.
Overall
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Was the information you received clear?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Was the information you received helpful?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
Would you call the KIPDA ADRC again in the future?
No, I don't think so
I'm not sure, I still have questions
Yes, I think so
9.
Would you like to thank a specific employee or provide positive feedback about your experience?
