Thank you for taking time out of your day to complete our survey!

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* 1. What location did you receive services from?

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* 2. Did you find the physical environment? (check all that apply)

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* 3. What services did you receive from OLHSA?

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* 4. Did OLHSA meet your needs?

  Yes or No Reason
Needs met?

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* 5. What services did you need that OLHSA did not have?

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* 6. Which of the following words would describe your experience at OLHSA?

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* 7. Did you find the staff to be? (check all that apply)

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* 8. Were you told about "other" OLHSA services?

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* 9. Any additional comments or concerns?

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* 10. If you would like to be contacted by our Customer Service Team please leave your contact information below.

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