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1. I am receiving the following service(s)?

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2. How do you feel about the help you are getting?

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3. How comfortable do you feel talking to your Worker or Therapist?

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4. How well do you think your worker or therapist understands you?

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5. How do you feel after you receive services or a therapy sessions?

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6. How do you feel about the activities and exercises during your sessions?

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7. What do you like the most about your services?

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8. What could be done better in providing services to you?

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9. How do you feel about the environment and setting you receive services in?

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10. Is there anything else you would like to share about your experience?

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