BGAAAIL ADRC Quality Assurance Survey Question Title * 1. Survey completed by: Client Caregiver Other Question Title * 2. I was able to reach someone when I called… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 3. If I had to leave a message, someone called me back within 1 business day... Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 4. If the first staff person could not help me, I was connected to someone that could… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 5. The staff person was friendly and courteous… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 6. The staff person answered my questions… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree Question Title * 7. The staff person gave me information that was useful to my situation… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 8. The staff person was knowledgeable about services in my community… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 9. It was easy to follow what the staff was telling me… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 10. Staff treated me in a professional manner… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 11. I would use the ADRC services again… Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree N/A Question Title * 12. How did you find out about the ADRC? Newspaper Brochure Website Friend/Relative Service Agency Other (please specify) Question Title * 13. Please offer any suggestions and/or comments Done