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SUPPORT COORDINATION SATISFACTION SURVEY
The primary job of the Support Coordinator is developing an annual support plan for each client and assist in accessing services needed. Support Coordinator then monitor those services to ensure they are being provided as authorized.
1.
Name of Individual served:
2.
Respondents Name:
3.
Relationship to Individual served:
4.
My current Support Coordinator is
Natalie Huebner
Danielle Powell
Amanda Taylor
Jessica Woodcock
5.
At your most recent plan meeting do you feel that your Support Coordinator listened and understood your needs and wants?
Yes
No
6.
About how often do you see your Support Coordinator?
Weekly
Monthly
Quarterly
Yearly
7.
Would you like to see her more often?
Yes
No
8.
Was the planning meeting held at a convenient location and time?
Yes
No
9.
Are/were you treated with courtesy and respect by your Support Coordinator?
Yes
No
10.
How would you rate your Support Coordinator overall?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
11.
Do you receive services from any of these providers? (check all that apply)
Enrichment Services
Covenant Care
Choices for People
TJ Swift
EasterSeals
HDIS/RSM
Other (please specify)
12.
How satisfied with the quality of services and programs offered to your family by these
providers?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
13.
Are there any issues we can help you resolve with these providers?
14.
Are there any services your family currently needs that are not available in Dent County?