Client - Program

We want to hear what YOU think about the program you have just completed at DYSS.
 
You can ask a staff for help completing it.
 
The information you give will be used to help us offer the best programs.
 
For each questions, please choose a number between 1 and 5.
 
1= Strongly Disagree  2= Disagree  3= Neutral  4= Agree  5= Strongly Agree

First name, Last Inital

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* 1. First name, Last Inital

Program 

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* 2. Program 

Please check what program you participated in

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* 3. Please check what program you participated in

Section One: What I think about the program
I liked being in the program

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* 4. I liked being in the program

I understood the program goals

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* 5. I understood the program goals

The program helped me

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* 6. The program helped me

I felt safe in the program

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* 7. I felt safe in the program

The program met my needs

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* 8. The program met my needs

I liked the program building and program materials

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* 9. I liked the program building and program materials

Select the words that best describe the program. (Select all that apply)

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* 10. Select the words that best describe the program. (Select all that apply)

Section Two: What I think about the staff
My Counsellor(s) were friendly

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* 11. My Counsellor(s) were friendly

My Counsellor(s) listened to me

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* 12. My Counsellor(s) listened to me

My Counsellor(s) were always fair to me

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* 13. My Counsellor(s) were always fair to me

My Counsellor(s) always helped me

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* 14. My Counsellor(s) always helped me

I felt respected by my counsellor(s)

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* 15. I felt respected by my counsellor(s)

My counsellor(s) set limits when necessary

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* 16. My counsellor(s) set limits when necessary

Select the words that best describe the staff. (Select all that apply)

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* 17. Select the words that best describe the staff. (Select all that apply)

Section Three: The program helped me to...
Stop and think before I act

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* 18. Stop and think before I act

Understand how my actions may affect others

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* 19. Understand how my actions may affect others

Take responsibility for my actions

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* 20. Take responsibility for my actions

To accept other people

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* 21. To accept other people

To gain new skills

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* 22. To gain new skills

To listen to others

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* 23. To listen to others

To better understand my feelings

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* 24. To better understand my feelings

To better solve problems

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* 25. To better solve problems

Write any other ways you think the program may have helped you

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* 26. Write any other ways you think the program may have helped you

Section Four: Final Questions
Do you think the program you completed could help other youth? Choose the answer that applies

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* 27. Do you think the program you completed could help other youth? Choose the answer that applies

Give a score between 1 and 10 to indicate your overall satisfaction with the program.

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* 28. Give a score between 1 and 10 to indicate your overall satisfaction with the program.

What would you change about the program

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* 29. What would you change about the program

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