Assessment: Customer Satisfaction Survey
Survey responses are anonymous; however, you can choose to be contacted by providing the information at the end of the form.
Q 1.1. What county do you live in?
< Choose >
Alcona
Alpena
Arenac
Cheboygan
Crawford
Iosco
Montmorency
Ogemaw
Oscoda
Otsego
Presque Isle
Roscommon
Other
Q 1.2. Which NEMCSA program(s) did you work with over the last year? Select all that apply.
Bridges of Self Sufficiency (BOSS)
Caregiver Health and Wellness Programs
Early Head Start (Ages 0-3)
Food Assistance
Head Start/Preschool (Ages 3-5)
Housing Assistance
Housing Counseling to purchase or rent a home
School Success Program for all grades
Self-Sufficiency Support
Senior Services
Utility Assistance
Volunteering
Weatherization
Q 1.3. Select the correct word to describe your overall family situation for each timeframe.
Successful
Stable
Safe
At Risk
In Crisis
Before working with NEMCSA:
After working with NEMCSA:
Q 1.4. Indicate whether you agree, disagree, or have no opinion on the following statements.
Agree
No opinion/ Not Applicable
Disagree
Staff treated me with dignity and respect.
Staff provided information in a way that was easy to understand.
Staff included my input in decisions related to my services and programs.
Staff were knowledgeable and helpful in completing paperwork and explaining program requirements.
NEMCSA staff connected me with additional programs and resources, if needed.
I enjoyed interacting with NEMCSA staff.
Q 1.5. The services provided by NEMCSA helped me meet my needs.
< Choose >
Yes
No
No Opinion/Doesn't Apply
Q 1.6. Explanation
Q 1.7. Rate your experience with NEMCSA.
< Choose >
5 - Excellent
4 - Good
3 - Neutral/ No Opinion
2 - Fair
1 - Poor
Stories shared here may be shared publicly without any identifying information.
Q 1.8. Tell us one thing NEMCSA programs and services have done for you and/or your family. (Optional)
Q 1.9. Share suggestions to help NEMCSA improve programs and services.
Q 1.10. Would you recommend NEMCSA to others?
< Choose >
Yes
No
No Opinion/Doesn't Apply
Q 1.11. Would you like someone from NEMCSA to contact you?
Yes
No
Q 1.12. Provide your name and contact information (email and/or phone number) as well as preferred time to call.
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