Community Connections Client Satisfaction Survey

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* 1. What is your gender Identity?

Female

Male

Not Specified

Other (please specify)

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* 2. Age

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* 3. Please indicate if you have received any of these services from Community Connections

Individual Counselling

Family Counselling

Couples Counselling

Attended PACT

Attended Bellies & Babies

Attended Revelstoke Secondary School Groups

Social Justice Advocate

Tenant Support Program

Housing Outreach Program

Food Bank

Food Recovery

Infant Development

Supported Child Development

Youth Program

Mentoring Program

Respite

Day Program

Residential Program

Supported Employment

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* 4. How helpful and relevant was the service(s)/information you received?

Not helpful

Somewhat helpful

Very helpful

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* 5. Were you satisfied with the service(s) you received?

Not satisfied

Somewhat satisfied

Very satisfied

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* 6. Did our service(s) have a positive effect for you?

Somewhat

Yes

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* 7. After receiving our service(s), do you feel that your emotional wellbeing is:

Better

Same

Worse

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* 8. After receiving our service(s), do you feel that your physical health is:

Better

Same

Worse

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* 9. After receiving our service(s), do you feel that your relationship with your family is:

Better

Same

Worse

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* 10. After receiving our service(s), do you feel that your relationship with your social group is:

Better

Same

Worse

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* 11. How courteous/caring/attentive/respectful were our staff in responding to your needs?

Very

Somewhat

Not

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* 1. What is your gender Identity?

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* 2. Age

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* 3. Please indicate if you have received any of these services from Community Connections

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* 4. How helpful and relevant was the service(s)/information you received?

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* 5. Were you satisfied with the service(s) you received?

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* 6. Did our service(s) have a positive effect for you?

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* 7. After receiving our service(s), do you feel that your emotional wellbeing is:

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* 8. After receiving our service(s), do you feel that your physical health is:

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* 9. After receiving our service(s), do you feel that your relationship with your family is:

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* 10. After receiving our service(s), do you feel that your relationship with your social group is:

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* 11. How courteous/caring/attentive/respectful were our staff in responding to your needs?

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* 12. Please use this space to comment further or elaborate on any of your above responses