Assistance Feedback Survey
Listening to Hearts of Gold participants has always been important to us. We are especially interested in hearing feedback from participants who have applied for assistance. In an effort to ensure that we are best meeting the needs of our participants, please take a moment to let us know about your experience. All responses are anonymous.
1.
How long have you been contributing to Hearts of Gold?
Less a year
1-5 years
5-10 years
Since the beginning (2008)
2.
Was the application easy to understand and complete? If not, how could it be improved?
Yes
No
If no, please explain:
3.
Was your application handled in a timely manner? If not, please explain what happened.
Yes
No
If no, please explain:
4.
How satisfied are you with the outcome of your request? If not satisfied, please explain.
Very satisfied
Somewhat satisfied
Not satisfied
Please explain:
5.
How satisfied were you with the confidentiality of your application? If not satisfied, please explain.
Very satisfied
Somewhat satisfied
Not satisfied
Please explain:
6.
Would you encourage others to become a participant or utilize Hearts of Gold? If not, please tell us why
Yes
No
If no, please explain:
7.
As a participant, how satisfied are you with Hearts of Gold? If not satisfied, please explain why.
Very satisfied
Somewhat satisfied
Not satisfied
Neutral/No opinion
Please explain:
8.
Would you encourage others to become a participant or utilize Hearts of Gold? If not, please tell us why
Yes
No
Please explain:
9.
Please let the Board know any other questions, comments, or concerns you may have regarding Hearts of Gold.