Your Feedback is Treasured! Your Feedback is Treasured Survey We are always trying to improve the services and supports we deliver. We value and appreciate receiving your compliments, suggestions or complaints (about us) so that we can improve our services and the way we communicate. OK Question Title * 1. Have you used our services in the past? (move to number 5 if you would like to learn about our services) Yes No OK Question Title * 2. Please select the service that you most recently used. Life Planning Support Community Participation Support (Community Living Sponsored Activities) Participation Support to access Activities in the Community Housing Support Employment Support (Adult) Summer Employment Transitions (Student) Day Support Options (via Wawanosh Innovation Centres) Children's Out of Home Family Respite Children and Youth Weekend Respite Children and Youth In-Hone Respite Summer Youth Adventures Adult's Out of Home Family Relief Weekend Retreats Sensational Saturdays Adult In-Home Relief Alhambra Days Other (please specify) OK Question Title * 3. Please rate your satisfaction level with the following: Very dissatisfied Dissatisfied Neutral Satisfied Very Satisfied Overall Satisfaction with the Service Overall Satisfaction with the Service Very dissatisfied Overall Satisfaction with the Service Dissatisfied Overall Satisfaction with the Service Neutral Overall Satisfaction with the Service Satisfied Overall Satisfaction with the Service Very Satisfied Ease of Access to the Service Ease of Access to the Service Very dissatisfied Ease of Access to the Service Dissatisfied Ease of Access to the Service Neutral Ease of Access to the Service Satisfied Ease of Access to the Service Very Satisfied Assistance by staff members Assistance by staff members Very dissatisfied Assistance by staff members Dissatisfied Assistance by staff members Neutral Assistance by staff members Satisfied Assistance by staff members Very Satisfied Length of time it took from requesting to receiving service Length of time it took from requesting to receiving service Very dissatisfied Length of time it took from requesting to receiving service Dissatisfied Length of time it took from requesting to receiving service Neutral Length of time it took from requesting to receiving service Satisfied Length of time it took from requesting to receiving service Very Satisfied OK Question Title * 4. If you have any additional comments, questions or suggestions, please fill them in here. OK Question Title * 5. If you would like to learn more about the services we offer, please provide your contact information. Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number OK DONE