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Axis Family Resources Ltd.
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Axis Family Resources Ltd.
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New Survey
New Survey:
Experience of Services Survey for Others - Stakeholders, family members or referral sources
Date Completed
*
Date Completed Date
Name of person completing survey
What is your connection to the Person Served or Program?
*
Community Partner
Family member
Referral Source
Name of the program you are providing feedback about
*
Child, Youth or Family Services
Community Living Services (Community Based services for Adults)
Specialized Supportive Housing
Substance Use Services
Name of the Person Served you are providing feedback about
Axis Office Location
*
100 Mile House
Cranbrook
Creston
Dawson Creek
Ft. St John
Kamloops
Kelowna
Penticton
Prince George
Quesnel
Salmon Arm
Vernon
Williams Lake
1.
No, not at all
Yes, the information was very useful
1
2
3
4
5
Was the information you received about the program useful in your decision-making for your family member or Person Served?
2.
No, not at all satisfied
Yes, very satisfied
1
2
3
4
5
Were you satisfied with the time frame for admission to services for the person served?
3.
Never
Definitely
1
2
3
4
5
Would you recommend the program to someone you know, or to another Person Served?
4.
No, not at all satisfied
Yes, very satisfied
1
2
3
4
5
Were you satisfied with the services and/or care your family member or client received from the program?
Comments