Type of Service Utilized:

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* 1. Type of Service Utilized:

Family Pride staff were prompt and helpful when starting services.

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* 2. Family Pride staff were prompt and helpful when starting services.

Family Pride staff spent time explaining the agency's services and policies so that my child/I could understand.

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* 3. Family Pride staff spent time explaining the agency's services and policies so that my child/I could understand.

Family Pride staff has included my thoughts and/or my child's thoughts and ideas in the treatment process

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* 4. Family Pride staff has included my thoughts and/or my child's thoughts and ideas in the treatment process

Family Pride staff has been accessible to me and/or my child if needed.

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* 5. Family Pride staff has been accessible to me and/or my child if needed.

I feel/felt comfortable with my Family Pride worker.

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* 6. I feel/felt comfortable with my Family Pride worker.

If applicable, Family Pride is responsive to my needs as a parent of a child in services with the agency.

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* 7. If applicable, Family Pride is responsive to my needs as a parent of a child in services with the agency.

Family Pride has been supportive of the my needs as a client and/or the needs of my child as a client.

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* 8. Family Pride has been supportive of the my needs as a client and/or the needs of my child as a client.

Family Pride services are consistent and helpful.

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* 9. Family Pride services are consistent and helpful.

I would recommend Family Pride to others.

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* 10. I would recommend Family Pride to others.

I feel positive about my/my family's progress.

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* 11. I feel positive about my/my family's progress.

Overall, how would you rate Family Pride's services?

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* 12. Overall, how would you rate Family Pride's services?

What aspects of services can be improved?

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* 13. What aspects of services can be improved?

Other comments/concerns?

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* 14. Other comments/concerns?

Name for follow-up (if wanted/optional)

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* 15. Name for follow-up (if wanted/optional)

Would you like a copy of the report?

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* 16. Would you like a copy of the report?

If yes, please provide your address:

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* 17. If yes, please provide your address:

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