Community Club Member Satisfaction Survey
Thank you for being a member of the Capabilities Community Club. Our goal is to help you successfully achieve and sustain your goals.
Please take a few minutes to complete this survey. Your feedback helps us serve you better.
1. Full Name:
Optional
Your answer
2. Email Address:
Optional
Your answer
How long have you been at the Community Club? *
4. How would you rate Capabilities on... *
Excellent
Very Good
Good
Fair
Poor
Unsure
Communication - Telling me what is going on
Listening Skills - Hearing me
Staff
Outing Choices
My Outing Choices
Feel my Personal Independence has Increased
Being part of the Community
5. How would you rate Capabilities Community Club overall? *
Excellent
Very Good
Good
Fair
Poor
Unsure
_
6. How likely are you to recommend Capabilities Community Club to other people? *
Excellent
Very Good
Good
Fair
Poor
Unsure
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7. Would you use Capabilities for other services? *
Excellent
Very Good
Good
Fair
Poor
Unsure
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8. What do we do well? What are we doing that you find useful? Tell us about someone from Capabilities if they went the extra mile for you. *
Your answer
9. How can we improve our services and the Community Club? *
Your answer
10. Did you know Capabilities has a website? *
11. Would you like to be featured on the website? *
If yes, please supply your contact information: *
Your answer
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