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Community Stakeholder Survey
United Family Recovery
COMMUNITY STAKEHOLDER SURVEY
The feedback we receive from persons throughout our community is something we take seriously in our efforts to improve our organization. We value your input and welcome your honesty in completing this community stakeholder survey.
Please complete our survey by selecting an answer below each question that best communicates your opinion. After completing the 10 questions, please provide additional comments and suggestions in the space provided.
Cultural Information
Race/Ethnicity:
Select
African American
Caucasian
Hispanic
Asian
Native American
Indian
Arabic
Other
Age:
Select
11 and under
12-17
18-21
22-29
30-39
40-49
50-59
60+
Gender:
Select
Male
Female
Transgender
Relationships
Number of years you have known about this organization:
Select
Less than 1 year
1-2 years
2-3 years
3-4 years
4+ years
Are you employed in an organization that refers persons to our services?
Yes
No
Please Select the Type/Focus of your oganization that most applies:
Criminal Justice
School/Public or Private Education
Physical Health
Mental Health
Vocational Rehabilitation/Education
Other
Relationship with persons who have participated in our services:
I have, or have had, a family member, friend, acquaintance, or a professional client who has participated in your services.
I have not had a direct relationship with anyone who has participated in your services.
Questions
When contacting us by phone, your call is answered in a prompt and courteous manner.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Our employees return phone calls and/or answer email messages in a timely manner.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Requests for information about our services, or about an individual receiving services, are responded to in a timely manner.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
I have been treated with respect each time I have had contact with your organization.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Persons who request services, and meet the requirments for admission to a program, are admitted in a timely manner.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Our organization treats all persons participating in services with respect.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Our employees are sensitive to differences in the cultural backgrounds of the persons receiving services.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Our organization encourages, and is open to feedback about the quality of our services.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Our organization is highly respected throughout the community for providing quality services.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
I would recommend your organization's services to a family member or friend, without hesitation.
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Accessibility to the program meets my expectations. (Please provide details in the comments section below).
Disagree Strongly
Disagree
Disagree Slightly
Agree Slightly
Agree
Agree Strongly
N/A
Comments
Please provide any
specific suggestions
you may have
for improving
our organization and our services:
Please provide any
additional comments
you may have related to your experience with our organization:
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