CCR&R Provider Services Satisfaction Survey

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* 1. For which CCR&R are you completing this survey?

Link

Choices

Connect

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* 2. Please indicate the type(s) of service you used. You may select more than one.

Trainings

Referrals to other programs (i.e., TRAILS, Behavior Specialist)

Referrals to other agencies (i.e., DHHR, United Way)

Referrals to other programs (i.e., Food Program, ACDS)

Provider Orientation\Consumer Education (you or families)

Assistance with payment forms

Assistance with Quality Tier level

Assistance with children/families in care

Provider Grant & Curriculum funds

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* 3. Did the agency staff present themselves in a professional manner?

Yes

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* 4. Were agency staff helpful?

Yes

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* 5. Were agency staff courteous?

Yes

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* 6. Were agency staff responsive within a reasonable time?

Yes

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* 7. Did you attend Provider Orientation within the past year?

Yes

Comments/suggestions about the orientation

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* 8. Do you receive the quarterly Provider Newsletters?

Yes

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* 9. If you receive the newsletter, by what method do you receive it?

Mail

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* 10. What articles/information in the newsletter do you find to be the most helpful to you?

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* 11. Have you contacted the CCR&R with any problems?

Yes

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* 12. If yes, what type of problem?

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* 13. Was the problem resolved to your satisfaction?

Yes

CCR&R Provider Services Satisfaction Survey

Question Title

* 1. For which CCR&R are you completing this survey?

Question Title

* 2. Please indicate the type(s) of service you used. You may select more than one.

Question Title

* 3. Did the agency staff present themselves in a professional manner?

Question Title

* 4. Were agency staff helpful?

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* 5. Were agency staff courteous?

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* 6. Were agency staff responsive within a reasonable time?

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* 7. Did you attend Provider Orientation within the past year?

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* 8. Do you receive the quarterly Provider Newsletters?

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* 9. If you receive the newsletter, by what method do you receive it?

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* 10. What articles/information in the newsletter do you find to be the most helpful to you?

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* 11. Have you contacted the CCR&R with any problems?

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* 12. If yes, what type of problem?

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* 13. Was the problem resolved to your satisfaction?

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* 14. Name (optional)

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* 15. Date