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* 1. Participant Name (optional):

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* 2. Date:

Date

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* 3. For each question, check the answer you think fits the best.

  Strongly Agree Agree Agree & Disagree Equally Disagree Strongly Disagree
I felt welcomed, accepted and valued.
I felt listened to and understood.
I was included in the development of my goals.
Goodwill staff had the skills to help me reach my goal(s).
The services I received met the needs I identified.
I have met or am closer to meeting my goals as a result of the services I received.
I would refer others to Goodwill for services.

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* 4. We welcome any comments you may have:

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