CFS Community Assessment Survey

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* 3. Overall, how satisfied or dissatisfied are you with our agency?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

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* 4. Which of the following words would you use to describe your interaction with the CFS staff ? Select all that apply.

Reliable

Informative

High quality

Useful

Ineffective

Poor quality

Unreliable

Uninformative

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* 5. How well does CFS meet your needs?

Extremely well

Very well

Somewhat well

Not so well

Not at all well

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* 6. How would you rate the quality of the service?

Very high quality

High quality

Neither high nor low quality

Low quality

Very low quality

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* 7. How responsive have we been to your questions or concerns about our services?

Extremely responsive

Very responsive

Somewhat responsive

Not so responsive

Not at all responsive

Not applicable

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* 8. How long have you been a client with CFS?

This is my first visit

Less than six months

Six months to a year

1 - 2 years

3 or more years

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* 9. How likely are you to use any of our services again?

Extremely likely

Very likely

Somewhat likely

Not so likely

Not at all likely

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* 10. What program/need would you recommend CFS add to our agency? What area are you wanting it in?

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* 11. Do you have any other comments, questions, or concerns?

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* 12. What is your age group?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 13. Gender?

Female

Male

Non-Binary

Other

Prefer Not To Answer

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* 14. Ethnicity?

Caucasian

African American

Latino/Hispanic

Asian

Native American

Native Hawaiian/Pacific Islander

Other

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* 15. Which county do you reside?

Blackford

Jay

Randolph

Adam

Huntington

Wells

CFS Community Assessment Survey

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* 1. How likely is it that you would recommend CFS to a friend or colleague?

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* 2. What program(s) have you used within CFS?

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* 3. Overall, how satisfied or dissatisfied are you with our agency?

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* 4. Which of the following words would you use to describe your interaction with the CFS staff ? Select all that apply.

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* 5. How well does CFS meet your needs?

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* 6. How would you rate the quality of the service?

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* 7. How responsive have we been to your questions or concerns about our services?

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* 8. How long have you been a client with CFS?

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* 9. How likely are you to use any of our services again?

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* 10. What program/need would you recommend CFS add to our agency? What area are you wanting it in?

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* 11. Do you have any other comments, questions, or concerns?

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* 12. What is your age group?

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* 13. Gender?

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* 14. Ethnicity?

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* 15. Which county do you reside?