Consumer Satisfaction Survey
Thank you for participating in the services provided by the Independent Living Resource Center (ILRC). Please select the best answer that rates the services you received from the agency during your time as a consumer.
1. How long have you been a consumer at the ILRC? *
2. Who set your independent living goals? *
3. Are the services you are receiving making you more independent? *
4. Did the ILRC staff members treat you with courtesy and respect? *
5. Overall, how satisfied are you with the services you are receiving from the ILRC? *
I am interested in further information from the ILRC in the following areas:
(Check all that apply)
Does The ILRC of Northeast Florida have permission to add you to our monthly email newsletter?
Clear selection
Your contact information below will be used to contact you with the additional information you requested on the areas marked above.
Phone Number
Email Address
Never submit passwords through Google Forms.
This form was created inside of