Client Experience Survey

Please correct the errors described below.

Please help us provide you with the best care possible by telling us how we’re doing and how we can improve.

Questions

How satisfied are you with the services we are providing? Please select an answer with 1 being completely dissatisfied and 10 being completely satisfied.

1 2 3 4 5 6 7 8 9 10

How likely are you to recommend us to your friends and family? Please select an answer with 1 being not at all likely and 10 being very likely.

1 2 3 4 5 6 7 8 9 10

Is there something we did particularly well?

Is there something we could improve?

About You

Age

Under 21 21 to 24 25 to 34 35 to 44 45 to 54 55 to 65 Over 65

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