Please complete the form below. Your identity will remain anonymous. Center For Family Services gave me written information about my rights and responsibilities Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable The people who work at Center For Family Services treat me with respect Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable I was told that information about me or the services I receive cannot be shared with other persons or other organizations without my written permission Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable Center For Family Services asks me how I think it could improve its services Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable Center For Family Services is easy for me to get to Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable The hours available for services at Center For Family Services are convenient for me Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable The buildings and offices at Center For Family Services are always clean Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable The atmosphere at the Center For Family Services is always respectful Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable The buildings at Center For Family Services feel safe Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable I received services within a reasonable period of time Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable If I pay a fee for services, it is reasonable Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable I help plan my services and set my goals Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable The services I receive at Center For Family Services are meeting my needs Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable Center For Family Services has helped me Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable I would recommend Center For Family Services to my family and friends Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable After my services have ended, I would come back to Center For Family Services if I needed help again Strongly Disagree Disagree Neutral Agree Strongly Agree Not Applicable Comments Thank you for completing this questionnaire. We will use this information to improve Center For Family Services.
