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Exit Survey - Rebound's Residential Program
REBOUND, INC - Residential Program Confidential Exit Survey. Please take a few moments to complete this survey.
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* Indicates required question
Which house did you stay at?
*
Jelani House
Naima House
How old are you?
*
14
15
16
17
Other:
Which race do you most identify with?
*
White (Caucasian)
Black or African American
Asia/Pacific Islander
American Indian
More than one race
Other:
Are you Hispanic?
*
Yes
No
Your Name
Your answer
What is your gender?
*
Female
Male
I received emotional support while in Rebound's facility/house.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
The food quality/amount met my needs.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
The sleeping accommodations met my needs.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
The recreation provided met my needs.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
At intake, the staff asked questions about my physical and emotional well-being.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I felt safe at the house.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I received support on my education plan, IEP, and/or educational services.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I received help from staff in getting medical and dental services.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
Throughout the duration of my time at rebound, I received support in reintegrating back into my family and community.
1
2
3
4
5
Clear selection
Throughout the duration of my time at rebound, my physical and emotional well-being needs were properly screened and attended to.
1
2
3
4
5
Clear selection
I received help from staff in getting mental health services.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
The staff provided attention to me during my treatment/program.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I received support for my transition plan, which included returning to my family and community.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I was treated with respect while at Jordan House.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
The staff at Rebound's House cares about my success.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I learned new skills while at Rebound's House.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I had input into my goal development.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I had input into my case plan.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
My family/significant other was involved in my program at Rebound.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
Could the Rebound Residential program have done something else to better serve you?
*
Your answer
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