Partners for Access Survey

Question Title

* 1. Please make a selection for each statement below:

	Strongly Agree	Agree	Mixed	Disagree	Strongly Disagree
I/we received the help I/we needed.	I/we received the help I/we needed. Strongly Agree	I/we received the help I/we needed. Agree	I/we received the help I/we needed. Mixed	I/we received the help I/we needed. Disagree	I/we received the help I/we needed. Strongly Disagree
Staff treated me/us with respect.	Staff treated me/us with respect. Strongly Agree	Staff treated me/us with respect. Agree	Staff treated me/us with respect. Mixed	Staff treated me/us with respect. Disagree	Staff treated me/us with respect. Strongly Disagree
I/we received the services that were right for me/us.	I/we received the services that were right for me/us. Strongly Agree	I/we received the services that were right for me/us. Agree	I/we received the services that were right for me/us. Mixed	I/we received the services that were right for me/us. Disagree	I/we received the services that were right for me/us. Strongly Disagree
The services that I/we received made a difference.	The services that I/we received made a difference. Strongly Agree	The services that I/we received made a difference. Agree	The services that I/we received made a difference. Mixed	The services that I/we received made a difference. Disagree	The services that I/we received made a difference. Strongly Disagree
My/our quality of life improved as a result of the services I/we received.	My/our quality of life improved as a result of the services I/we received. Strongly Agree	My/our quality of life improved as a result of the services I/we received. Agree	My/our quality of life improved as a result of the services I/we received. Mixed	My/our quality of life improved as a result of the services I/we received. Disagree	My/our quality of life improved as a result of the services I/we received. Strongly Disagree

Question Title

* 2. I would recommend Partners for Access to a friend or colleague.

10: Extremely Likely

9

8

7

6

5: Neutral

4

3

2

1: Not at all Likely

10: Extremely Likely

9

8

7

6

5: Neutral

4

3

2

1: Not at all Likely

Question Title

* 3. Is there anything else you would like to say about your experience with Partners for Access (for example, what you found helpful or what you would like to see improved?)