CAPNCM Customer Satisfaction Survey

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* 1. What county do you live in?

Caldwell

Daviess

Grundy

Harrison

Linn

Livingston

Mercer

Putnam

Sullivan

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* 2. What was the purpose of your visit/call? (optional)

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* 3. How did you learn about CAPNCM? (word-of-mouth, newspaper, radio, online, etc)

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* 4. What CAPNCM services have you utilized as a client?

Emergency Assistance

Housing/Rental Assistance

Housing Development

Weatherization

Women's Health Services

Employment & Training

Family Support

Energy Assistance/LIHEAP

Other

If "Other", please comment

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* 5. Please rank the following aspects of your visit to/contact with Community Action Partnership of North Central Missouri.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	N/A
The office was easy to find, well marked, & convenient.	The office was easy to find, well marked, & convenient. Strongly Agree	The office was easy to find, well marked, & convenient. Agree	The office was easy to find, well marked, & convenient. Neutral	The office was easy to find, well marked, & convenient. Disagree	The office was easy to find, well marked, & convenient. Strongly Disagree	The office was easy to find, well marked, & convenient. N/A
The CAPNCM office was clean, tidy, & comfortable.	The CAPNCM office was clean, tidy, & comfortable. Strongly Agree	The CAPNCM office was clean, tidy, & comfortable. Agree	The CAPNCM office was clean, tidy, & comfortable. Neutral	The CAPNCM office was clean, tidy, & comfortable. Disagree	The CAPNCM office was clean, tidy, & comfortable. Strongly Disagree	The CAPNCM office was clean, tidy, & comfortable. N/A
I met with staff at or near the time of my appointment.	I met with staff at or near the time of my appointment. Strongly Agree	I met with staff at or near the time of my appointment. Agree	I met with staff at or near the time of my appointment. Neutral	I met with staff at or near the time of my appointment. Disagree	I met with staff at or near the time of my appointment. Strongly Disagree	I met with staff at or near the time of my appointment. N/A
I didn’t have an appointment, but was served in a timely manner.	I didn’t have an appointment, but was served in a timely manner. Strongly Agree	I didn’t have an appointment, but was served in a timely manner. Agree	I didn’t have an appointment, but was served in a timely manner. Neutral	I didn’t have an appointment, but was served in a timely manner. Disagree	I didn’t have an appointment, but was served in a timely manner. Strongly Disagree	I didn’t have an appointment, but was served in a timely manner. N/A
Staff were courteous, respectful, friendly, and helpful.	Staff were courteous, respectful, friendly, and helpful. Strongly Agree	Staff were courteous, respectful, friendly, and helpful. Agree	Staff were courteous, respectful, friendly, and helpful. Neutral	Staff were courteous, respectful, friendly, and helpful. Disagree	Staff were courteous, respectful, friendly, and helpful. Strongly Disagree	Staff were courteous, respectful, friendly, and helpful. N/A
Staff was sensitive to my situation and needs.	Staff was sensitive to my situation and needs. Strongly Agree	Staff was sensitive to my situation and needs. Agree	Staff was sensitive to my situation and needs. Neutral	Staff was sensitive to my situation and needs. Disagree	Staff was sensitive to my situation and needs. Strongly Disagree	Staff was sensitive to my situation and needs. N/A
My need or reason for today’s visit was taken care of.	My need or reason for today’s visit was taken care of. Strongly Agree	My need or reason for today’s visit was taken care of. Agree	My need or reason for today’s visit was taken care of. Neutral	My need or reason for today’s visit was taken care of. Disagree	My need or reason for today’s visit was taken care of. Strongly Disagree	My need or reason for today’s visit was taken care of. N/A
CAPNCM could not meet my need(s), but I was referred to other provider(s).	CAPNCM could not meet my need(s), but I was referred to other provider(s). Strongly Agree	CAPNCM could not meet my need(s), but I was referred to other provider(s). Agree	CAPNCM could not meet my need(s), but I was referred to other provider(s). Neutral	CAPNCM could not meet my need(s), but I was referred to other provider(s). Disagree	CAPNCM could not meet my need(s), but I was referred to other provider(s). Strongly Disagree	CAPNCM could not meet my need(s), but I was referred to other provider(s). N/A
Staff offered information about other services available.	Staff offered information about other services available. Strongly Agree	Staff offered information about other services available. Agree	Staff offered information about other services available. Neutral	Staff offered information about other services available. Disagree	Staff offered information about other services available. Strongly Disagree	Staff offered information about other services available. N/A
CAPNCM helps improve the condition in which low-income people live.	CAPNCM helps improve the condition in which low-income people live. Strongly Agree	CAPNCM helps improve the condition in which low-income people live. Agree	CAPNCM helps improve the condition in which low-income people live. Neutral	CAPNCM helps improve the condition in which low-income people live. Disagree	CAPNCM helps improve the condition in which low-income people live. Strongly Disagree	CAPNCM helps improve the condition in which low-income people live. N/A

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* 6. Since participating in CAPNCM services, are you and your family:

more self-supporting

less self-supporting

no change

prefer not to answer

If you feel more self-supporting, what specific assistance do you feel helped you the most?

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* 7. Overall, how do you rate the quality of services we provide?

Excellent

Good

Adequate

Poor

Unacceptable

Comments

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* 8. What level of confidence do you have in us to deliver the services that you require?

Complete

A lot

Some

Little

None

Comments

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* 9. Would you be interested in sharing your story with others?

Yes

Not Sure

If yes, please provide your contact information in the box below.

CAPNCM Customer Satisfaction Survey

How Are We Doing?

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* 1. What county do you live in?

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* 2. What was the purpose of your visit/call? (optional)

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* 3. How did you learn about CAPNCM? (word-of-mouth, newspaper, radio, online, etc)

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* 4. What CAPNCM services have you utilized as a client?

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* 5. Please rank the following aspects of your visit to/contact with Community Action Partnership of North Central Missouri.

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* 6. Since participating in CAPNCM services, are you and your family:

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* 7. Overall, how do you rate the quality of services we provide?

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* 8. What level of confidence do you have in us to deliver the services that you require?

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* 9. Would you be interested in sharing your story with others?

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* 10. If you have any suggestions regarding how we could improve the services we provide to you, please enter them in the box below.