Thank you for working with RSVP, Inc. Your satisfaction with our services is of the utmost importance. We welcome your feedback and suggestions.

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1. Please enter your name. (Required.)

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2. Please enter the RSVP, Inc. Specialist's Name (Required.)

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3. Please select the current service status: (Required.)

Please select the most appropriate response to the following statements.

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4. I have input when making a job choice. (Required.)

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5. I feel like I was helped to get ready to work in the community. (Required.)

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6. I was asked to participate with my job search. (Required.)

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7. I have learned new job skills. (Required.)

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8. My job goal fits my interests. (Required.)

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9. I have reliable transportation. (Required.)

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10. I am treated with respect by RSVP, Inc. staff and employers. (Required.)

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11. I feel safe in the community. (Required.)

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12. I have identified a salary goal. (Required.)

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13. I enjoy the job preparation/development process. (Required.)

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14. I like working with RSVP, Inc. Specialists. (Required.)

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15. I receive SSI/SSDI disability benefits. (Required.)

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16. I am able to maintain my SSI/SSDI disability benefits? (Required.)

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17. I receive Medicaid (SSI), Medicare (SSDI), or other Health Benefits? (Required.)

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18. I am able to maintain my Medicaid (SSI), Medicare (SSDI), or other Health Benefits? (Required.)

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19. I have out-of-pocket disability-related work expenses (i.e., transportation, medications, supplies, etc.) (Required.)

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20. Things I like about my services/outcome: (Required.)

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21. Things I do not like about my services/outcome: (Required.)

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22. Date Survey Completed (Required.)

Date
Please click Done to submit your completed survey.

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