Welcome to the Taking Control Program Consumer/Employer and Assistant Program Feedback Survey

This is your opportunity to tell us what is going right, what is going wrong, and how to make things better.

Please answer the following questions to help WNYIL make your experiences with the Taking Control Program the best they can be. If you wish for us to follow up with you personally on any of the concerns/issues you raised, please provide your name and contact information at the end of the survey.  Otherwise, your responses will be strictly anonymous.

Please identify the problems you encounter when you are recruiting for assistants (choose all that apply).

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* 1. Please identify the problems you encounter when you are recruiting for assistants (choose all that apply).

I need help… (choose all that apply).

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* 2. I need help… (choose all that apply).

I would like to know…(choose all that apply).

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* 3. I would like to know…(choose all that apply).

I lose my assistants because…(choose all that apply).

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* 4. I lose my assistants because…(choose all that apply).

Please explain any other issue(s) you are having difficulty with regarding the Taking Control Program.

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* 5. Please explain any other issue(s) you are having difficulty with regarding the Taking Control Program.

Please explain any idea(s) you may have to help WNYIL make the Taking Control Program better for you.

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* 6. Please explain any idea(s) you may have to help WNYIL make the Taking Control Program better for you.

I would like to report to WNYIL, Inc. what I believe is a wrongful act of fraud, waste, or abuse of the Taking Control Program. Please contact me for further details using the contact information provided in Question 8.

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* 7. I would like to report to WNYIL, Inc. what I believe is a wrongful act of fraud, waste, or abuse of the Taking Control Program. Please contact me for further details using the contact information provided in Question 8.

I would like a Taking Control Representative to contact me about a personal concern I have about my participation in the Taking Control program:

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* 8. I would like a Taking Control Representative to contact me about a personal concern I have about my participation in the Taking Control program:

Thank you for completing the Taking Control Feedback Survey. 
Your responses will assist WNYIL in improving your interaction and experience with the Taking Control Program. 

If you have witnessed fraud, waste, or abuse of the Taking Control Program please contact Tina Brown at tbrown@wnyil.org or our anonymous toll-free number 1-866-576-8042.

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