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* 1. Region you received support from?

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* 2. Are you?

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* 3. What Pride In North Carolina Services did you ( or your family member) receive?

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* 4. Overall I am satisfied with the quality of services provided by Pride in North Carolina, LLC.

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* 5. Overall I feel my/ my child/family member's quality of life has improved or changed for the better since receiving services and supports from Pride in North Carolina, LLC.

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* 6. I/My family member is/am better able to handle problems since receiving services from Pride in North Carolina, LLC.

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* 7. Pride in North Carolina, LLC. staff treated me with respect and honored any cultural needs or preferences I requested.

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* 8. What specifically were some of the cultural needs/preferences you requested or expressed?

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* 9. Based on my experience, Pride in North Carolina, LLC.

  Yes No Unknown (n/a)
Was effective at serving me in a timely manner upon admission.
Utilizes and encourages a Child and Family approach to children's services.
Is effective at responding to and de-escalating crisis situations.
I felt my/my family's interaction with Team Lead/Therapist met my/family needs.
The schedule of serivces was based on my input/needs rather than the team/staff member.

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* 10. Please add any comments, concerns or feedback that would assist us in program improvement or service delivery.

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