JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ICAA Customer Feedback
We would love to hear your thoughts or feedback on how we can improve your experience!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
How did you hear about ICAA?
*
Brochure/Rack Card
Friend/Family
Internet Search
Referral from another organization
Facebook/Instagram/Linked
Required
Which ICAA program(s) have you participated in?
*
CSBG Emergency Services
Connections Store - Thrift Store & Emergency Clothing/Assistance
Early Head Start - Child Care Partnerships
Family Foundations Home Visiting
Family Resource Center
Head Start
Legal Assistance for Victims
Supportive Services for Veteran Families
Youth Homeless Demonstration Project
Required
How was the enrollment/application process?
*
Very Easy
Easy
Neither easy nor difficult
Difficult
Very difficult
ICAA employees treated me with respect and were sensitive to my situation and needs.
*
Strongly Agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
ICAA employees were NOT able to meet my needs, but I was referred to other resources.
*
Strongly Agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
What barriers (personal or physical) keep you from seeking assistance?
Internet/Phone
Transportation
Personal Feeling
Not understanding the process
Other:
Do you have any feedback or comments for ICAA?
Your answer
Would you like to be contacted?
Yes. If yes, please provide contact information (name, email, phone, etc.)
No
Clear selection
Name
Your answer
Phone
Your answer
Email
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report