Voluntary Customer Satisfaction Survey 2023

You are important to us!

We want to make sure that every contact you have with CAPWI is positive and pleasant.

You can help us to serve you better by completing this survey. Your comments and suggestions are very much appreciated.

Question Title

* 1. Overall, how would you rate the program or services you received?

Excellent

Good

Fair

Poor

Question Title

* 2. How would you rate the way staff treated you?

Excellent

Good

Fair

Poor

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* 3. How would you rate the reliability of the program staff in doing what they said they would do?

Excellent

Good

Fair

Poor

Question Title

* 4. How would you rate the timeliness in responding to you or your issue?

Excellent

Good

Fair

Poor

Question Title

* 5. If you had a friend or family member in need of the same or similar service you received, how likely would you recommend the program or service?

Highly likely

Likely

Unlikely

Highly unlikely

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* 6. How likely are you to seek services from our agency again?

Highly likely

Likely

Unlikely

Highly unlikely

Question Title

* 7. Were you informed of other programs in our agency that you might be interested in or for which you qualify?

Yes

No

Not Applicable

Question Title

* 8. If the services you requested were not available through our agency, were you referred to another agency or resource?

Yes

No

Not Applicable

Question Title

* 9. Please provide any additional comments about your experience you would like to share.

Question Title

* 10. Which county did you receive services?

Benton

Fountain

Montgomery

Parke

Vermillion

Warren

Question Title

* 11. Would you like for us to contact you?

Email Address

Phone Number