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* 1. Client/child

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* 2. Name of person completing survey

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* 3. Contact phone number

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* 4. On a scale of 1-10 how likely are you to recommend Easterseals Central Illinois to a friend or family member? ( 1-6 would not recommend, 7-8 might recommend, 9-10 would recommend)

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* 5. Please share why you selected your rating?

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* 6. Please share your thoughts below

  Strongly Disagree Disagree Neither Agree/ Disagree Agree Strongly Agree
Communication with my family has been timely
Communication with my family has been accurate
3. Communication with my family has been compassionate

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* 7. Are you willing to answer a few more questions about your experience?

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