Exit 211 DuPage Satisfaction Survey Question Title * 1. Did you learn about a new resource through 211 DuPage? Yes No Client Doesn't Know Client Refused Data Not Collected Question Title * 2. Did you receive the information you needed to contact an appropriate service provider? Yes No Client Doesn't Know Client Refused Data Not Collected Question Title * 3. Have you tried to contact any of the organizations you were referred to by 211 DuPage? Yes (complete next question) No longer need service Not what I requested Resource did not sound promising Has not but is planning to contact No response Question Title * 4. If answered yes to question #3: Did you receive or are you receiving services from one of the organizations you were referred to by 211 DuPage? Yes No Question Title * 5. If answered no to question #4: Why not? On waiting list In process of applying Agency has not returned contact yet Funding was not available Program not accepting new applications/waitlist closed Could not obtain necessary documentation to obtain services Not eligible for service Transportation issues Service hours/location issues Referral information is inaccurate Other Please enter additional information about referrals or accessing services. Question Title * 6. Ask the caller about each need listed in CallPoint:"You called regarding ____________. Was your need met?"Update the Outcome of Need box in CallPoint and check the box below confirming this step has been completed. Complete Question Title * 7. Overall, were your expectations of 211 DuPage met? Yes No Client Doesn't Know Client Refused Data Not Collected Question Title * 8. Would you recommend 211 DuPage services to a friend or family member? Yes No Client Doesn't Know Client Refused Data Not Collected Question Title * 9. Do you have any other feedback about 211 DuPage? Done
