Which agency services are you currently receiving?
Food assistance
Cash assistance
Medical assistance
Transportation assistance
Child Care assistance
Prevention, Retention, Contingency assistance
Kinship assistance
Foster/Adoption assistance
Child Protective services
Adult Protective services
How long have you been receiving benefits?
recently applied for the first time
intermittently as needed
5 years or less
more than 5 years
Please check the statements you agree with:
I understood what services were available to me
I understood if I was eligible or wasn't eligible for benefits
Contact was provided timely
Benefits were provided timely
How would you rate your overall experience with our agency?
5 being the best service possible
1
2
3
4
5
Please explain your answer:
Were there services you needed or expected but did not receive? Please explain.
Were there barriers in obtaining needed services? Please explain:
What do you feel are the agency's strengths?
In what ways do you feel our agency could improve?
Thank you for completing this survey. Please add any additional comments here:
