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* 1. Please select the case manager you recently worked with

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* 2. Case management has helped me with the following (select all that apply)

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* 3. Staff were professional and knowledgeable

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* 4. Staff followed through as needed in a timely manner

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* 5. Communications are clear and concise

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* 6. Fully attentive to your needs and requests

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* 7. Complaints and/or concerns have been addressed in a timely manner

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* 8. Other comments and/or suggestions:

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* 9. Please leave your name and number if you would like to speak to someone regarding your recent visit with case management.

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