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Client / Family Satisfaction Survey

This satisfaction survey is how we evaluate the our program and services.
It is Important that you provide us with details for us to improve our services.

Client / Family Satisfaction Survey

Inital Contact

Overall how would you rate your first interaction with our Team?
Excellent
Good
Fair
Poor
Ease of Reaching Us
Excellent
Good
Fair
Poor
Friendliness & Professionalism
Excellent
Good
Fair
Poor
Knowledge & Helpfulness
Excellent
Good
Fair
Poor
Response Time
Excellent
Good
Fair
Poor

Intake & Acessment Process

Overall how satisfied were you with the intake / start up Process
Excellent
Good
Fair
Poor
Clarity of information
Excellent
Good
Fair
Poor
Understanding of clients needs
Excellent
Good
Fair
Poor
Professionalism of the Accessor
Excellent
Good
Fair
Poor
Timeliness to Start Services
Excellent
Good
Fair
Poor

Scheduling & Coordination

Overall How would you rate our scheduling and coordination?
Excellent
Good
Fair
Poor
Ease of Booking the Service
Excellent
Good
Fair
Poor
Consistency of Scheduling
Excellent
Good
Fair
Poor
Communication of Changes
Excellent
Good
Fair
Poor
Flexibility to meet needs
Excellent
Good
Fair
Poor

Communcation with the Office, Billing, Administration

How Satisfied are you with the Communication & Administration of the Agency?
Excellent
Good
Fair
Poor
How is the communication from the Office?
Excellent
Good
Fair
Poor
How is the clarity of the invoice?
Excellent
Good
Fair
Poor
Accuracy of the billing
Excellent
Good
Fair
Poor
Ease of Payment
Excellent
Good
Fair
Poor
Responsiveness to Payment Questions
Excellent
Good
Fair
Poor

Support Worker Preformance

Overall Satisfaction with Support workers
Excellent
Good
Fair
Poor
Respect & Professionalism
Excellent
Good
Fair
Poor
Reliable & Punctuality
Excellent
Good
Fair
Poor
Quality of Care Provided
Excellent
Good
Fair
Poor
Compassion & Engagement
Excellent
Good
Fair
Poor
Understanding of Clients Needs
Excellent
Good
Fair
Poor
Support worker appearance
Excellent
Good
Fair
Poor

Strengths

Recommendation

Would you Recommend Our services to others?
Yes
No
Maybe

Follow-Up

Would you Like a member of our team to reach out to you to discuss these results?
Yes
No
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Individual Support Worker Survey

Do you wish to remain Anonymous?
Yes
No

Overall Satisfaction with Support Worker

Overall Satisfaction with the Support Worker
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied

Professionalism & Conduct

Respect and Courtesy
Excellent
Good
Fair
Poor
Professional Attitude
Excellent
Good
Fair
Poor
Appearance & Hygiene
Excellent
Good
Fair
Poor
Maintains Boundaries
Excellent
Good
Fair
Poor
Cell Phone Usage
Minimal
Acceptable
Alot
Excessive

Reliable & Dependablility

Arrives to work on time
Excellent
Good
Fair
Poor
Communicates delays/changes
Excellent
Good
Fair
Poor
Takes initiative when appropriate
Excellent
Good
Fair
Poor
Works independently
Excellent
Good
Fair
Poor
Problem-solving ability
Excellent
Good
Fair
Poor

Compassion & Engagement

Kindness & empathy
Excellent
Good
Fair
Poor
Engagement with client
Excellent
Good
Fair
Poor
Patience
Excellent
Good
Fair
Poor
Builds trust & comfort
Excellent
Good
Fair
Poor

Quality of Care

Meets care needs
Excellent
Good
Fair
Poor
Follows care plan
Excellent
Good
Fair
Poor
Attention to safety
Excellent
Good
Fair
Poor
Attention to detail
Excellent
Good
Fair
Poor

Communication

Attention to detail
Excellent
Good
Fair
Poor

Strenghts & Weakness

Comfort & Trust

Do you feel comfortable having this support worker providing care for you or your loved one?
Yes, completely
Mostly
Somewhat
Not at all
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Welcome to

Maritime Respite Services
Available on Prince Edward Island Now

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