Center for Life Resources Needs Assessment for Individuals Receiving Services Survey

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* 5. If you are age 16 and over, what is your current employment situation?

Self-Employed

Employed Full-time

Employed Part-time

Stay at home spouse/parent

Disabled and not able to work

Retired

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* 6. Are you presently or have you been in the US Armed Forces?

Yes

No, skip to question 9

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* 7. Select your current status.

Active

Reserve

National Guard

Honorable Discharge

Discharge or release under conditions other than dishonorable

Dishonorable Discharge

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* 8. In which branch of the US Armed Forces did or are you servicing?

Army

Marine Corp

Navy

Airforce

Space Force

Coast Guard

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* 9. How did you hear about the services offered by Center for Life Resources (CFLR)?

Family/Friend

Community Event

Radio

Church

Primary Care Provider

Law Enforcement

Judicial System

School

FaceBook

Instagram

cflr.us website

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* 10. Please select all the services you receive from Center for Life Resources.

Autism Services

Early Childhood Intervention Services (case management, PT/OT/SLT)

Case Management/Service Coordination

Skills Training/psychosocial rehab

Counseling

Outpatient Substance Use Treatment

Crisis Services

Crisis Respite Services

ICF

Texas Home Living or HCS services

Psychiatric Medications and Monitoring

Supported Employment

Supported Housing

Assertive Community Treatment

Family Partner/Peer Services

Veterans Services

JCI Services ( Apprenticeship, ISS, etc.)

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* 11. How do you most often receive these services?

Face to Face in person

Video appointment

Phone appointment ( audio only no video)

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* 12. Please rate your satisfaction with the services you receive.

Not Satisfied

Sometimes Satisfied

Mostly Satisfied

Satisfied

Not Satisfied

Sometimes Satisfied

Mostly Satisfied

Satisfied

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* 13. To what extend would you agree with the following statements?

	Yes	No	Sometimes
I was involved in planning my care.	I was involved in planning my care. Yes	I was involved in planning my care. No	I was involved in planning my care. Sometimes
Staff spent enough time with me.	Staff spent enough time with me. Yes	Staff spent enough time with me. No	Staff spent enough time with me. Sometimes
What I had to say was respected.	What I had to say was respected. Yes	What I had to say was respected. No	What I had to say was respected. Sometimes
I was listened to carefully.	I was listened to carefully. Yes	I was listened to carefully. No	I was listened to carefully. Sometimes
Things were explained to me in a way that i could understand.	Things were explained to me in a way that i could understand. Yes	Things were explained to me in a way that i could understand. No	Things were explained to me in a way that i could understand. Sometimes

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* 14. Overall, were the services you received convenient and accessible for you?

Yes

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* 15. Please identify the main 3 reasons the services were not convenient or accessible for you.

I didn't have tranportation.

Service not offered at a good time for me.

Service not offered on a good day for me.

I can't afford internet service for telehealth service.

My internet service is too slow for telehealth service.

My cell phone service is poor and spotty.

I didn't have any cell phone minutes.

I didn't receive appointment reminders

I am homeless.

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* 16. Would you recommend service at CFLR to a family or friend

Yes

Please add any comments.

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* 17. How could CFLR more effectively serve you?

Send me appointment reminders.

Increase staffing so that I have the time I need.

Increasing counseling staff so that I can receive that service.

Help me get set up int the patient portal for reminders.

Make appointments available before 8 am and after 5 pm.

Other (please specify)

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* 18. Which language do prefer to speak and for services to be provided?

English

Spanish

German

Korean

French

Vietnamese

Chinese

Tagalog

Hindu

Arabic

Russian//Polish/ or other Slavic language

Other Indo-European language

Other Asian and Pacific Island language

Other (please specify)

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* 19. Were the service provided in the language you prefer?

Yes

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* 20. Do you know how to file a complaint if you are not satisfied with services?

Yes

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* 21. How did you learn how to file a complaint? Select all that apply

My Rights Handbook.

Center staff told me.

I saw it on the bulletin board.

I saw it on the CFLR website.

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* 22. If you wish to be in a drawing for a backpack style cooler, please leave your full name and a working phone number so that if you are randomly selected we can contact you when our survey closes in March of 2025.

Center for Life Resources Needs Assessment for Individuals Receiving Services

We want to hear from you.

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* 1. In what county do you current live?

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* 2. What is your age?

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* 3. What is your birth gender?

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* 4. What is the highest level of school that you completed or highest degree received?

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* 5. If you are age 16 and over, what is your current employment situation?

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* 6. Are you presently or have you been in the US Armed Forces?

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* 7. Select your current status.

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* 8. In which branch of the US Armed Forces did or are you servicing?

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* 9. How did you hear about the services offered by Center for Life Resources (CFLR)?

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* 10. Please select all the services you receive from Center for Life Resources.

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* 11. How do you most often receive these services?

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* 12. Please rate your satisfaction with the services you receive.

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* 13. To what extend would you agree with the following statements?

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* 14. Overall, were the services you received convenient and accessible for you?

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* 15. Please identify the main 3 reasons the services were not convenient or accessible for you.

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* 16. Would you recommend service at CFLR to a family or friend

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* 17. How could CFLR more effectively serve you?

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* 18. Which language do prefer to speak and for services to be provided?

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* 19. Were the service provided in the language you prefer?

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* 20. Do you know how to file a complaint if you are not satisfied with services?

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* 21. How did you learn how to file a complaint? Select all that apply

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* 22. If you wish to be in a drawing for a backpack style cooler, please leave your full name and a working phone number so that if you are randomly selected we can contact you when our survey closes in March of 2025.