Consumer Satisfaction Survey
Center for Independence of Individuals with Disabilities Logo
CID values and appreciates your participation in this voluntary survey. Your feedback will be used to improve and enhance our programs. No personal identifying information is required. Thank you.

Please check all responses that apply.

1. Are you:
2a How did you find out about CID?
2b. If you selected another agency or newsletter, which one did you hear about CID from?
Your answer
3. When you contacted CID for assistance, staff responded
4. After contacting CID, did you receive any of the following services?
4A. Do you feel the services you received helped you to increase your independence?
5. After contacting CID, did you receive any of the following information on:
5A. Do you feel the information helped you to increase your independence?
6. Did CID staff treat you with respect and was staff sensitive to your disability?
7. Overall, were you satisfied with the service(s) you received and would you refer someone to CID in the future?
8. As a result of your interactions with CID, have you participated in any disability-related advocacy or educational activities?
8A. If "yes", select all of the topics or issues that apply:
9. With regard to the services or assistance you obtained from CID, were your disability-related accommodation needs met?
9A. If "NO," please explain:
Your answer
10. With regard to the services or assistance you obtained from CID, were your language translation needs met?
10A. If no, please explain:
Your answer
Is there anything else that you would like for us to know about your experience with CID?
Your answer
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