We Value Your Feedback

Instructions: Please take a moment to answer the following two questions regarding your experience using our program.

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* 1. On a scale of zero to ten, how likely are you to recommend our program to a friend or colleague?

0 5 10
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i We adjusted the number you entered based on the slider’s scale.

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* 2. What is the primary reason for your score (select one)?

Instructions: Please take a moment to answer the following questions regarding your experience using our program.

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* What services did you receive (check all that apply)?

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* Please rate the program's ease of access:

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* Please rate the level of support you received from your Care Advocate when you first accessed the program:

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* If you participated in counseling, please rate your overall satisfaction with the counseling services provided:

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* If you received a legal or financial consultation, please rate your overall satisfaction with the legal or financial services provided:

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* If you requested resources or referrals for child care, elder care or other services, please rate the quality of the information and referrals that you received:

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* Please rate the effectiveness of the program in helping you address or resolve your concern(s):

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* Overall, how would you rate your experience using the program.

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