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Axis Family Resources Ltd.
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New Survey
New Survey:
CLS and SSH Services - Experience of Services Survey for Persons Served
Person Served Name
Program you have received services from
*
Community Living Services (Community Based services for Adults)
Specialized Supportive Housing
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, did not experience this
:) Yes, felt I was treated this way by my staff
1
2
3
4
5
Have you been treated with dignity and respect while receiving services from Axis?
2.
:( Not at all
:) Yes, really well
1
2
3
4
5
Have the program staff supported you to focus on the goals you have for yourself?
3.
:( Not at all
:) Yes, really well
1
2
3
4
5
Were services provided in a way that worked well for you?
4.
:( Not at all
:) Yes very much so
1
2
3
4
5
Did you get information from your program staff about other services you could access following our service?
5.
:( Lots was missing
:) Nothing major was missing
1
2
3
4
5
N/A
Was there anything missing for you in the services and resources we provided?
6.
:( Did not feel this way at all
:) Yes felt very included on a team
1
2
3
4
5
Have you felt included as part of a team working together to help you achieve your goals?
7.
:( Not at all
:) Yes felt they were included
1
2
3
4
5
Did you feel that other members of your family or important people in your life had a chance to be included in your support from Axis?
8.
:( No
:) Yes
1
2
3
4
5
Do you feel that you have had an opportunity to participate in more community outings during your time receiving services from Axis?
Comments
Date Completed
*
Date Completed Date