Client Satisfaction Survey Please help us understand how to improve the quality of our services by completing the survey below. Thank you for your feedback! 1. Which of the following Action Inc. services have you used? Advocacy (i.e., help with benefits) QUEST Emergency Shelter Housing First Our Place COMPASS Adult Education Nurse Aide Training Program CDL Training Program Fuel Assistance Weatherization Other Advocacy (i.e., help with benefits)GreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffQUESTGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffEmergency ShelterGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffHousing FirstGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffOur PlaceGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffCOMPASSGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffAdult EducationGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffNurse Aide Training ProgramGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffCDL Training ProgramGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffFuel AssistanceGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffWeatherizationGreatGoodFairPoorHelpfulness of ProgramHelpfulness of StaffPlease specify "OTHER" services received:Please rate "OTHER" program mentioned above:GreatGoodFairPoorHelpfulness of ProgramHelpfulness of Staff2. What did Action Inc. do that helped you and/or your family?3. Respond to this statement:Since receiving services from Action Inc., my family is better off.Strongly agreeSomewhat agreeNeutralDisagreeStrongly disagreePlease explain:4. Overall, how do you rate the quality of Action Inc.'s services?GreatGoodFairPoorUnacceptablePlease explain:5. What can Action Inc. do to improve our services?6. Did Action Inc.'s staff refer you to other service providers or organizations?YesNoWas this referral helpful to you?Very helpfulSomewhat helpfulNeutralNot helpfulPlease explain:7. How did you learn about Action Inc.? Family or friend Newspaper Facebook/website Word of mouth Other Other:Contact InformationName (Optional)Phone Number (Optional)E-Mail (Optional)Would you like to share your story to help us spread the word about our services?YesNo
