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Client Satisfaction Survey
1.
How did you find out about the Homeless Coalition of Polk County and their referral services?
Other Organizations
211 United Way, Findhelp.org
Word of Mouth
Social Media
Other
Other (please specify)
2.
During the assessment do you feel your housing needs were captured?
Yes
No
Additional Comments
3.
How clearly did the representative explain the referral process following your intake?
1 star
2 stars
3 stars
4 stars
5 stars
Additional Comments
4.
Overall, how would you rate the quality of your experience with the representative?
Very positive
Somewhat positive
Neutral
Somewhat negative
Very negative
Additional Comments
5.
What was the name of the representative?
6.
When you found yourself facing homelessness, where was the first place you contacted for assistance?
7.
Do you have any questions that you feel would have been important to ask on the housing assessment?