Easterseals Central Illinois Family Survey Question Title * 1. Client/child Question Title * 2. Name of person completing survey Question Title * 3. Contact phone number Question Title * 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) 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Question Title * 5. Please share why you selected your rating? Question Title * 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 timely Strongly Disagree Communication with my family has been timely Disagree Communication with my family has been timely Neither Agree/ Disagree Communication with my family has been timely Agree Communication with my family has been timely Strongly Agree Communication with my family has been accurate Communication with my family has been accurate Strongly Disagree Communication with my family has been accurate Disagree Communication with my family has been accurate Neither Agree/ Disagree Communication with my family has been accurate Agree Communication with my family has been accurate Strongly Agree 3. Communication with my family has been compassionate 3. Communication with my family has been compassionate Strongly Disagree 3. Communication with my family has been compassionate Disagree 3. Communication with my family has been compassionate Neither Agree/ Disagree 3. Communication with my family has been compassionate Agree 3. Communication with my family has been compassionate Strongly Agree Question Title * 7. Are you willing to answer a few more questions about your experience? Sure! No thank you, submit my answers Next