RISE Client Satisfaction Survey
Thank you for trusting RISE during your time of need. We are committed to providing quality services to sexual assault/abuse and intimate partner violence survivors and their friends and family. By completing this survey, you are helping us to better meet your needs.

We appreciate your willingness to share your thoughts.

1. Please indicate the services accessed at RISE:
Mark all that apply
2. Please indicate the number of times you have had contact with our agency:
6+
3. Please rate the overall service you received from our agency:
Poor
Outstanding
4. Please rate the quality of services regarding: Information Provided
Poor
Outstanding
Please rate the quality of services regarding: Availability
Poor
Outstanding
Please rate the quality of services regarding: Empathy/Understanding
Poor
Outstanding
Please rate the quality of services regarding: Ability to meet your needs
Poor
Outstanding
Please rate the quality of services regarding: Follow-up
Poor
Outstanding
5. Please describe any additional services we could provide:
Your answer
6. How could we improve our services?
Your answer
7. We want to respect you as a unique individual. Do you feel we respected your personal experiences and background (e.g. age, ethnicity, gender, sexual orientation, religion, or ability)?
Your answer
Please use this space for any additional comments:
Your answer
Gender:
Your answer
Age:
Your answer
8. May we quote you anonymously so that others might understand how you were helped?
9. May we mention your age?
10. May we mention your gender?
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This form was created inside of RISE. Report Abuse - Terms of Service