1. Service Characteristics

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Please take a few minutes to complete this survey on the quality of service we provide. We welcome your feedback and appreciate your honesty. With your help, we hope to improve services provided to our clients, families and referral agency.

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* 1. Please enter client's first and last name:

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* 4. Select which time frame survey is being completed for:

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* 5. Please rate the following questions.

  Excellent Above Average Average Below Average Poor N/A
Satisfaction of services received.
Communication with LCYDC Staff.
Availability of LCYDC Staff when needed.
Learned new skills while in care that will help in the future.
Ability to express own ideas and ask questions.
Involvement in making decisions about services needed.
Reviewed and received information about Client Rights and Responsibilities.
Safety during my placement and/or visits with LCYDC staff.
Protection of privacy and confidentiality while receiving services from LCYDC.
Fairness of rules and guidelines of LCYDC.
Services received at Chanticleer Learning Center (Educational Services).
Services received from Psychological Services.