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* 1. Date

Date

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* 2. How likely is it that you would recommend Empowering Minds to a friend or colleague?

Not at all likely
Extremely likely

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* 3. Which of the following words would you use to describe our services? Select all that apply.

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* 4. How well does our services meet your needs?

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* 5. How would you rate the quality of the services you agency receives?

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* 6. How responsive have we been to your questions or concerns about the clients you refer?

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* 7. How likely are you to refer your clients to Empowering Minds PRP?

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* 8. How long have you been a Partner/Stakeholder/Referral Source of Empowering Minds?

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* 9. Overall, how satisfied or dissatisfied are you with agency?

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* 10. Do you have any other comments, questions, or concerns?

T