Social Services would love to hear your opinion!

Filling out this survey will not affect the services you get. 

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* 1. Today's Date 

Date

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* 2. Program

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* 3. Please  select your answer about the service you received:

  Yes No Doesn't Apply to Me
The meeting place was easy to get to.
The meeting place was comfortable.
I got connected to the services I was looking for.
I was treated with respect.
Staff answered my questions.
I am satisfied with the service I received.
Staff were sensitive to my cultural/ethnic background

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* 4. What did you like best about the services you received?

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* 5. How can we make our services better?

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* 6. Does your household have any unmet needs? If yes, what are your needs?

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* 7. Do you have anything else you want to share with us?

You don't have to answer, but it would help us to know:

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* 8. Gender

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* 9. Age

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* 10. Have you served in the military?

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* 11. Race/Ethnicity/Culture (Check all that apply):

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* 12. Would you like to talk with a staff member about your feedback? If so, give us your name and contact information. We will get back to you within 10 business days.

Thank you for your valuable time and input. Your opinion and feedback will help make sure that we provide the highest quality services to our community!

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