New Hope Industries, Inc. Provider Survey
As a Client of New Hope, how satisfied are you with our services?
First and Last Name (Optional)
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Email - Address (Optional)
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Phone Number (Optional)
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Customer Service
1. Do the staff provide assistance when you request it?
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2. Do the staff assist you in learning new information about the person served? (ei... reinforcers etc.)
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3. Do the staff provide activities that the person served likes?
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4. Does the day program/work place have enough work or activities to keep the person served busy?
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5. Does the day Program/Work place have enough staff to help you?
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6. Does the day program/work place have enough space?
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Customer Rights
1. Are the day program/work place staff nice to the person served?
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2. Do the staff allow the person served to make choices?
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3. Do the staff listen to the person served?
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Health and Safety
1. Do you feel the Program/work place is safe?
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2. Does the day program/work place teach the person served what to do in an emergency?
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3. Is the day program/work place building clean?
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Customer Satisfaction
1. Do you like the staff?
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2. Are you happy with the day program/work place provider?
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3. Do the staff do a good job at your day program/work place?
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Customer Transportation
1. Does the person served feel safe when being transported to and from the day program/work site?
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2. Are the vehicles comfortable?
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3. Is your driver nice to you?
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4. Does the person served have a long ride to/from your day program/work place?
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Additional Comments
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