Home at Heart Care Client Satisfaction Survey Question Title * 1. Overall, how satisfied or dissatisfied are you with Home at Heart Care? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied Question Title * 2. Which of the following words would you use to describe our services? Select all that apply. Reliable High quality Useful Compassionate Trustworthy Responsible Expensive Intrusive Poor quality Unreliable Question Title * 3. How well do our Care Givers meet your needs? Extremely well Very well Somewhat well Not so well Not at all well Question Title * 4. How would you rate the quality of care you receive? Very high quality High quality Neither high nor low quality Low quality Very low quality Question Title * 5. How does your Care Giver reflect Home at Heart Care' core values, of Trust, Hospitality, Compassion, Responsibility? Excellent Above average Average Below average Poor Question Title * 6. How responsive have we been to your questions and concerns? Extremely responsive Very responsive Somewhat responsive Not so responsive Not at all responsive Not applicable Question Title * 7. How long have you used Home at Heart Care as your provider? This is my first year 1 year 2-3 years 4-6 years 7-10 years I'm not a client Question Title * 8. What services do you receive? Personal Care Assistance 245D Homemaking Housekeeping 245D Respite Services Private Pay Homemaking Question Title * 9. How likely is it that you would recommend this company to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 10. Do you have any other comments, questions, or concerns? Next