Consumer Survey

1. Please indicate the services you now receive or have received in the past from one of the following centers: *

REACH of Fort Worth Resource Center on Independent Living

REACH of Dallas Resource Center on Independent Living

REACH of Denton Resource Center on Independent Living

REACH of Plano Resource Center on Independent Living

2. I have been treated in a friendly, caring, and respectful manner by the Center’s staff. *

Comments

3. The Center’s staff responds to me and provides services in a timely manner? *

Comments

4. The Center’s services are meeting and/or have met my needs? *

Comments

5. I am satisfied with the services provided by the Center and staff. *

Comments

6. The Center’s services and staff provide me with information to help me make informed choices? *

Comments

7. The Center’s staff encouraged me to make decisions so that I may live more independently? *

Comments

Based on your experience, what could the Center do to improve services?

What additional services would you like the Center to be able to provide?

What services in the community do you need that are not currently available?

How did you become aware of the Center’s programs and services?

What services do you need or want from the Center that we are not providing?

Contact Information

If you would like a Center employee to follow up with you, please give us your full name and contact information:

Your Name

E-mail

Phone

Address

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