Service Provider Survey
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Restoring Hope, LLC
Thank you for allowing Restoring Hope to be your service provider. We appreciate the opportunity!
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1.
My relationship with Restoring Hope is...
(Required.)
Individual that receives services
Guardian for an individual that receives services
Family member of an individual that receives services
Support Coordinator
If Other (please specify)
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2.
What service(s) do you receive from Restoring Hope? Check all that apply.
(Required.)
Host Home
Individualized Supported Living (ISL)
Day Program (Excel)
Out-of-Home Respite
In-Home Respite
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3.
How satisfied are you with the services you receive from Restoring Hope?
(Required.)
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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4.
I am treated with courtesy and respect by Restoring Hope staff.
(Required.)
Always
Usually
Sometimes
Rarely
Never
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5.
How responsive do you feel Restoring Hope is to your needs?
(Required.)
Extremely responsive
Very responsive
Somewhat responsive
Not so responsive
Not responsive at all
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6.
Would you recommend Restoring Hope services to others?
(Required.)
Yes
No
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7.
What region are you located in?
(Required.)
Central Missouri
Joplin
Kansas City
Kirksville
Poplar Bluff
Rolla
Sikeston
Springfield
St. Louis
8.
Do you have any additional feedback or suggestions you would like to share?
Current Progress,
0 of 8 answered
