Cuyahoga DD Feedback Survey

Thank you for partnering with Cuyahoga DD. We are grateful to be able to support you or your family member. We want you to know that we are here for you.

Our goal is to provide you with excellent service. For us to do that, we need to know how we're doing. We cannot improve unless we know what we are doing well and what needs to be better. Feedback surveys are a great way for us to get the information we need, while providing you with a simple way to communicate with us.

Thank you for completing our Feedback Survey!

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* 1. The first and last name of the Cuyahoga DD staff member you wish to survey is:

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* 2. I am the...

Individual Served

Family Member

Guardian

Other (please specify)

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* 3. Does our staff person treat you with kindness/respect?

Always

Sometimes

Never

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* 4. When you contact our staff, how quickly do you hear back from them?

Same day

1-2 days

3-5 days

More than 5 days

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* 5. Does our staff understand your needs?

Always

Sometimes

Never

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* 6. Has our staff been able to gain your trust?

Always

Sometimes

Never

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* 7. Does our staff explain things in a way that you understand?

Always

Sometimes

Never

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* 8. Is there anything else that you would like to share?

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* 9. Would you like to speak with someone regarding your experience?

Yes

If you answered "YES" please provide your name and telephone number below.