Adult Services Community Friends Survey

Satisfaction*

Please select a response indicating how satisfied or dissatisfied you are with New Hope Services:

	Very Dissatisfied	Somewhat Dissatisfied	Neutral/No Opinion	Satisfied	Very Satisfied
Response Time and Communication
Knowledgeable Staff and Management
Level of Respect and Professionalism
Overall Quality of Client Services

Referral Likelihood*
On a scale of 1 - 10, how likely are you to refer someone to New Hope Services?
1 - Not Likely At All 2 3 4 5 - Somewhat Likely 6 7 8 9 10 - Extremely Likely
Improves Lives*
Overall, do you feel that New Hope Services improves the lives of adults with disabilities?
- YES
- NO
- N/A or Don't Know
Increases community integration*
Overall, do you feel that New Hope Services increases community integration for adults with disabilities?
- YES
- NO
- N/A or Don't Know
Provides important community services*
Overall, do you feel that New Hope Services provides important and necessary services to the community?
- YES
- NO
- N/A or Don't Know
Feedback
Please leave us feedback to better explain your responses above:
Improvements we could make
Please let us know if there are any processes, services, or improvements that you feel we could implement to enhance our current quality of care:
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