Please answer the following questions so we can evaluate how well we have responded to your/your family’s needs. Your participation in this survey is voluntary and all of your answers will be anonymous.
For statements 3-15, please choose the most appropriate answer to tell us if you agree or disagree with the statements. For the remaining questions, please write your answers in the space provided.

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* 1. How many sessions with a worker did you/your child have:

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* 2. ) I/my child received services in:

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* 3. I participated in my/my child’s treatment.

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* 4. The worker helped me/my child to develop treatment goals that met my/my child’s needs.

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* 5. I/my child felt heard and respected by the worker.

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* 6. The worker identified both strengths and needs in my/our family.

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* 7. Other family members and I were invited to participate in my/my child’s treatment as needed.

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* 8. My/my child’s culture was respected and taken into consideration by the worker.

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* 9. The worker was able to effectively communicate with me/my child in the official language of my/our choosing.

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* 10. NEOFACS staff  communicated well with each other and with and me/my child.

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* 11. I am/my child is more able to manage difficulties than before treatment.

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* 12. The services I/my child received allowed me/my child to meet my goals/my child’s goals.

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* 13. I have/my child has strengthened skills and abilities because of the services provided.

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* 14. I have/my child has less needs and symptoms because of the services provided.

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* 15. I would recommend NEOFACS to other families.

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* 16. Please describe your/your child’s reasons for ending service (check all that apply)

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* 17. What did NEOFACS do well?

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* 18. What change(s) can NEOFACS make that would have the biggest positive impact on the service you/your child received?

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* 19. Additional Comments:

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