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Consumer Satisfaction Survey
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* Indicates required question
Tell us which services you requested?
*
Advocacy
Peer Mentoring
Information and Referral
Skills Training
Required
Did you receive the service/services requested?
*
Yes
No
Required
Are you a registered voter?
*
Yes
No
Required
In which county do you reside?
*
Berkeley
Chareston
Dorchester
Orangeburg
Williamsburg
Required
What mode of transportation did you use to get to our office?
*
Personal
Family
Friend
Para-transit
Service Agency
Other
Required
Services were provided in a timely manner.
*
Lowest
1
2
3
4
5
Highest
The staff treated me with respect.
*
Lowest
1
2
3
4
5
Highest
The staff responded and returned my calls.
*
Lowest
1
2
3
4
5
Highest
The information was provided in an accessible format.
*
Lowest
1
2
3
4
5
Highest
I gained new knowledge while working with the Center for Independent Living (CIL)
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Lowest
1
2
3
4
5
Highest
I learned a new skill while working with CIL.
*
Lowest
1
2
3
4
5
Highest
My situation improved while working with CIL.
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Lowest
1
2
3
4
5
Highest
My overall growth to live independently improved.
*
Lowest
1
2
3
4
5
Highest
Please rate your overall satisfaction with today's visit.
*
Lowest
1
2
3
4
5
Highest
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