Yuba-Sutter ADRC Consumer Experience Survey

Please complete this by July 12th, 2024.

The Yuba-Sutter Aging and Disability Resource Connection (ADRC) is a partnership between the local Agency on Aging Area 4 (AAA4), FREED Center for Independent Living, and local agencies providing services to people with disabilities and older adults. The ADRC focuses on providing the following core services:

1. Enhanced Information, and Assistance
2. Person Centered Options Counseling
3. Short Term Service Coordination
4. Person Centered Transition Support

Your local ADRC would like to learn about your experience with the services and program received between July 1st, 2023 and June 30th, 2024. Please complete one survey for each person who received services. If you are a caregiver, please answer the questions on how the ADRC supported your interests and needs as a caregiver.

This survey should take less than five minutes and will help us learn how helpful we are to you and what we could do better to meet your need(s).

Please share your experience. It is greatly appreciated. Thank you!

* 7. What, if anything, could we have done better?

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* 8. What kind of help or services were you looking for?

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* 9. Based on your experience, what did you find helpful? Please select those that may apply. [*Optional Question]

I received information and referrals for services.

I said what my goals were and I was given choices to help meet my needs.

I received help for an urgent need.

I received help going back to my home after being in a hospital or other place that cared for me.

I did not find the program helpful.

Other (please list)

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* 10. May we contact you to discuss your experience?

Yes

Yuba-Sutter ADRC Consumer Experience Survey

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* 1. Are you a:

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* 2. My interests and needs were discussed.

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* 3. I was treated with courtesy and dignity.

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* 4. I have more information and choices because of the services/assistance I received.

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* 5. I am more confident that I will be able to manage my life better because of the services/assistance I received.

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* 6. The services/assistance I received improved my health, safety, and/or well-being.

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* 7. What, if anything, could we have done better?

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* 8. What kind of help or services were you looking for?

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* 9. Based on your experience, what did you find helpful? Please select those that may apply. [*Optional Question]

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* 10. May we contact you to discuss your experience?

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* 11. If you answered "Yes" to number 10, please provide your phone number below.