To thank you for taking the time to give us your feedback, all consumers can enter into a drawing for a gift card. If interested, please give us your name and phone. Drawing will be at the end of September.
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1. Are you a:
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2. Which county do you reside in?
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3. The primary support received from Access North was (i.e. PCA, Home Mods, ILS, etc.)
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4. Which staff did you work with? If more than one, please be specific.
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5. Was the staff polite, respectful and timely?
Please tell us of your experience
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6. Was the person receiving services involved in the planning, direction and activities of the services received:
7. Was the person receiving services given thorough and accurate information about the programs and services received?
Comment
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8. The person receiving services had increased access to affordable and adequate …
9. The person receiving services experienced an increase in independence and personal growth.
10. On a scale of 1 to 5, how satisfied are you with the services received from Access North?
Very Unsatisfied
Very Satisfied
11. What groups or classes would you like to see us offer and in which communities do you see this need?
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12. IF YOU HAVE ANY FURTHER COMMENTS … Please provide them here so that we can improve our services:
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