We believe it is important to get your input on the quality of the services you received. Please tell us how we did so that we can serve you and others better in the future. Please answer all questions on this survey.
COUNSELING AGENCY:   H.E.L.P. Community Development Corp.

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* HOUSING ADVISOR NAME:

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* Date of Service or First Appointment

Date

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* Today's Date

Date
Counseling Services Received
Please indicate the counseling or education service you received.

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* Which counseling service did you receive?

Quality of Services Received
Please rate the quality of the services provided from 1 (Very Poor), 2 (Poor), 3 (Neutral), 4 (Good), and 5 (Excellent).
If a question is not applicable or you do not wish to respond to that question, check the box NA.

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* Did you feel welcomed and comfortable during your visit?

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* Did the Housing Advisor listen to your questions and concerns?

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* Was the information provided easy to understand?

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* Did you feel that the Housing Advisor explained your options clearly?

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* Did you learn something new that will help you with your housing goals?

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* Did the Housing Advisor help you feel more confident about the next steps?

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* Were you satisfied with the amount of time given to answer your questions?

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* How likely are you to recommend this service to a friend or family member? (use a scale: Unlikely, Likely, or Very Likely)

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* Do you feel better prepared to make decisions about housing after this visit?

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* Is there anything you wish had been explained better?

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* Would you come back to us if you needed more help in the future?

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