Individual Satisfaction Survey
Is the Direct Care Staff on time? *
Does the Direct Care Staff follow the Individual Support Plan (ISP) *
Is the Direct Care Staff respectful to you and your rights? *
Does the Direct Care Staff work the scheduled amount of hours? *
Does the Program Coordinator return your calls promptly? *
Have you had any complaints or concerns not addressed? *
Are you satisfied with your current Direct Care Staff? *
Have you had the need to call the office? *
If yes, when you call the office, is our staff courteous? *
Do you need services which are not provided? *
If so, what services?
Your answer
What can we do to improve our services?
Your answer
How would you rate our overall services? *
Poor
Great
Direct Care Staff Name
Your answer
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