1. Service Characteristics

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Please take a few minutes to complete this survey on the quality of service we provide. We welcome your feedback and appreciate your honesty. With your help, we hope to improve services provided to our clients, families and referral agency.

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* 1. Please enter client's first and last name:

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* 4. Select which time frame survey is being completed for:

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* 5. Please rate the following questions.

  Excellent Above Average Average Below Average Poor N/A
Satisfaction of services received.
Communication with LCYDC Staff as needed.
Availability of LCYDC Staff when needed.
New skills learned by client in care that will help in the future.
Opportunity to participate in treatment planning.
Ability to give input on services provided to client.
Client was informed of all rules and guidelines provided by LCYDC.
Safety of environment for the client at LCYDC.
Protection of privacy and confidentiality of client served at LCYDC.
Chances of referring another client to LCYDC.