Stakeholder Satisfaction Survey
We would love to hear your thoughts or feedback on how we can improve your experience!
* Required
I make referrals to AFE's CORE Services Program
*
Yes
No
I make referrals to AFE's DFCS Family Preservation Program
Yes
No
Clear selection
I make referrals to AFE's School-Based Mental Health Program
Yes
No
Clear selection
I am able to make referrals to AFE programs with ease and confidence
*
Not at all
1
2
3
4
5
All the time
AFE staff members are courteous and professional.
*
Not at all
1
2
3
4
5
All the time
AFE staff members sufficiently answer questions that I have about the program
*
Not at all
1
2
3
4
5
All the time
I am able to readily make contact with agency staff and my phone calls / emails are returned in a timely fashion.
*
Not at all
1
2
3
4
5
All the time
Once a referral has been made, an initial assessment is conducted by program staff within a timely fashion.
*
Not at all
1
2
3
4
5
All the time
I am made aware of referral disposition after an initial assessment has been conducted.
*
Not at all
1
2
3
4
5
All the time
I am satisfied with the level of contact that the program maintains throughout treatment.
*
Not at all
1
2
3
4
5
Very Satisfied
I receive positive feedback from consumers and families regarding AFE services.
*
Not at all
1
2
3
4
5
All the time
I would refer others to programs at AFE.
*
Not at all
1
2
3
4
5
Definitely
Suggestions for improvement
Your answer
Name
*
Your answer
Date:
MM
/
DD
/
YYYY
What organization do you represent?
Please also include what county you come from (e.g. Henry: DFCS; Clayton: Pediatrics of Clayton; Rockdale: Springfield Baptist Church)
Your answer
Email
*
Your answer
Phone Number
Your answer
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