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Client and Guardian Satisfaction Survey
1.
I am a Client or Guardian?
I am a Client
I am a Guardian
2.
I received a client/guardian handbook?
Yes
No
N/A
3.
I participate in choosing my care provider?
Yes
No
N/A
4.
I know my client rights & responsibilities?
Yes
No
N/A
5.
I participate in developing my personal centered plan?
Yes
No
N/A
6.
The agency treats me with dignity & respect?
Yes
No
N/A
7.
I have the opportunity to make choices for myself at the agency?
Yes
No
N/A
8.
Overall, I am pleased with the support I receive from agency?
Yes
No
N/A
9.
I know how to voice my concerns at the agency?
Yes
No
N/A
10.
Would you recommend this agency as a great place to receive services?
Yes
No
N/A
11.
I have received services from the agency for?
< 1 year
1-5 years
> 5 years
Current Progress,
0 of 11 answered
