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Thanks for your response and for helping improve services!

For survey assistance please contact communications@olhsa.org.

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* 1. What County do you live in?

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* 2. What is your race and/or ethnicity? Select all that apply.

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* 3. Was it easy to contact OLHSA?

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* 4. Which services did you receive from OLHSA? Check all that apply.

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* 5. What specific service(s) did you receive?

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* 6. Did OLHSA meet your needs?

  Yes or No Reason
Needs met?

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

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

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

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

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* 11. Any additional comments or concerns?

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* 12. If you would like to be contacted about your responses, please leave your contact information below (name/phone/email).

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