Client Satisfaction Feedback
To ensure continuous improvement, we are requesting that you complete the following survey. Your participation is important in improving the quality and effectiveness of future services.
OK
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1.
Select your county:
(Required.)
Haywood
Madison
Henderson
Chester
Hardeman
McNairy
Hardin
Decatur
Weakley
Henry
Benton
Carroll
Gibson
Lauderdale
Tipton
Fayette
Please provide county if not listed:
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2.
Was this your first time to receive services from this agency?
(Required.)
Yes
No
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3.
Do you feel that you received fair treatment during the process of applying for assistance?
(Required.)
Yes
No
If no, please share any detail if you can?
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4.
Select what services you have used:
(Required.)
Head Start
Transportation
Utility Assistance
Commodities
Probation/DUI School
Housing Repair
Homemaker
Meals on Wheels
Tech Helps
SSBG
Case Management
Rep Payee/Financial Management Services
Summer Food
At Risk
Foster Grandparent
Senior Job Training
Other (please specify)
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5.
Do you feel that you were treated with respect and dignity?
(Required.)
Yes
No
Other (please specify)
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6.
Overall, were you satisfied with the experience?
(Required.)
Yes
No
Other (please specify)
