Family/Care Provider Satisfaction Survey

We're committed to monitoring and evaluating the quality of the services we provide, as part of an ongoing improvement process. We would appreciate your feedback on our performance. (All submissions are anonymous.)

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* 1. How would you rate the services you receive from Options For All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
The level of communication between you and Options For All

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* 2. How would you rate the services you receive from Options for All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
The degree of professionalism and level of competence of Options For All staff

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* 3. How would you rate the services you receive from Options For All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
The manner in which Options for All staff interact with your son/daughter/(person served)

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* 4. How would you rate the services you receive from Options For All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
Your opportunity to be involved with your son's/daughter's/(person served)services?

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* 5. How would you rate the services you receive from Options For All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
Your son's/daughter's/(person served) employment opportunities

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* 6. How would you rate the services you receive from Options For All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
The overall management and supervision of your son's/daughter's/(person served) services

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* 7. How would you rate the services you receive from Options For All in terms of (Rating of 5 being highest, 1 being lowest):

  5 - Excellent 4 - Good 3 - Okay 2 - Poor 1 - Very Poor
Being a valued member or part of the planning process for your son/daughter/(person served)

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* 8. Have there been any significant changes in your son's/daughter's/(person served) health in the past year? (If yes, please explain)

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* 9. Are there any barriers (changes to transportation, loss of funding) that are making it difficult for your son/daughter/(person served) to receive services from Options For All? (If yes, please explain)

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* 10. What other services would you like to see Options For All provide?

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* 11. Is there anything else the staff and management of Employment & Community Options can do for you?

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* 12. In what type of program and/or geographic location of Options For All is your son/daughter or person served enrolled?

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