Consumer Satisfaction Survey - Working

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

Question Title

1. Please enter your name. (Required.)

Name

Question Title

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

RSVP, Inc. Specialist's Name

Question Title

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

Initial

Ongoing

Follow-Along

Case Closure

Please select the most appropriate response to the following statements.

Question Title

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

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

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

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

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

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

7. I like the job I obtained. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

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

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

9. My job fits my interests. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

10. I have reliable transportation to and from my job. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

11. I am treated with respect on my job. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

12. I feel safe on my job. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

13. I have friends at work. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

14. I get along with my co-workers. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

15. I am satisfied with my salary. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

16. I am enjoying my job. (Required.)

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

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

False

Somewhat False

Uncertain

Somewhat True

True

Question Title

18. I receive SSI/SSDI disability benefits.

Yes

Question Title

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

Yes

Question Title

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

Yes

Question Title

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

Yes

Consumer Satisfaction Survey - Working

Question Title

* 1. Please enter your name. (Required.)

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

* 7. I like the job I obtained. (Required.)

Question Title

* 8. I have learned new job skills. (Required.)

Question Title

* 9. My job fits my interests. (Required.)

Question Title

* 10. I have reliable transportation to and from my job. (Required.)

Question Title

* 11. I am treated with respect on my job. (Required.)

Question Title

* 12. I feel safe on my job. (Required.)

Question Title

* 13. I have friends at work. (Required.)

Question Title

* 14. I get along with my co-workers. (Required.)

Question Title

* 15. I am satisfied with my salary. (Required.)

Question Title

* 16. I am enjoying my job. (Required.)

Question Title

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

Question Title

* 18. I receive SSI/SSDI disability benefits.

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

* 25. Date Survey Completed (Required.)

1. Please enter your name. (Required.)

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

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

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

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

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

7. I like the job I obtained. (Required.)

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

9. My job fits my interests. (Required.)

10. I have reliable transportation to and from my job. (Required.)

11. I am treated with respect on my job. (Required.)

12. I feel safe on my job. (Required.)

13. I have friends at work. (Required.)

14. I get along with my co-workers. (Required.)

15. I am satisfied with my salary. (Required.)

16. I am enjoying my job. (Required.)

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

18. I receive SSI/SSDI disability benefits.

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

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

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

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

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

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

25. Date Survey Completed (Required.)