ACHIEVE DISABILITY SERVICES Client Feedback Survey Question Title * 1. How did you first hear about our Disability Support Service? Internet search Social media Referral from a friend or family member Healthcare provider Advertisement Other Question Title * 2. What was the primary reason you chose our services over other options? Reputation Range of services Recommendation Location Other Question Title * 3. Which of our services have you used? (Select all that apply) Community Participation Support groups In-home care Transportation services Other Question Title * 4. Overall, how satisfied are you with the services provided by our Disability Support Service? Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied Question Title * 5. How could we have gone above and beyond to better meet your needs? Question Title * 6. Do you have any suggestions for how we can improve our services? Question Title * 7. How likely is it that you would recommend our disability support service to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 8. Is there anything else you would like to share about your experience with our Disability Support Service? Question Title * 9. Please provide your name (optional) Question Title * 10. Please provide your email address (optional) Done