We want to make our agency better for you. Can you answer some questions for us? Don't worry, your answers are private and won't change the help you or your family get now or later.
If you are a guardian/family member, please respond to the questions on behalf of your dependent. 

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* 1. Who is completing this survey?

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* 2. How long have you been receiving services with this agency?

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* 3. What is your member status?

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* 4. Race: How do you identify?

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* 5. Gender: How do you identify?

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* 6. What is your age?

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* 7. I am satisfied with the services I receive.

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* 8. I feel People Incorporated staff believes in my ability to succeed.

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* 9. People Incorporated staff tries their best to help.

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* 10. Compared to when you started working with People Incorporated, how much do your feelings or thoughts get in the way of your daily life now?

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* 11. The staff person/people that I work with are:

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* 12. I would tell my friends and family to check out People Incorporated if they needed help.

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* 13. I am treated well and with respect.

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* 14. I am included in my care decisions.

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* 15. My care team communicates well with me. 

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* 16. Additional Comments:

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* 17. Please tell us the name of the program that gave you this survey.

Do you want to tell us something more about People Incorporated? You can email us at info@peopleincorporated.org. We will answer you soon.

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