Client Satisfaction Survey - Heartland Health Resource Center

Name

First Last

Participation*

I am an active Ryan White Part B client.
I have received services through Heartland Health Resource Center in the past 6 months.
I have not completed this survey in the past 6 months.

I am satisfied with the services that I receive.*

If I had other choices, I would get services from this agency.*

When contacting this agency, I am treated with respect.*

Staff members are willing to see me as often as necessary and make time for me as needed.*

My phone calls are returned in a timely manner.*

Staff members assist me in setting goals and believe I can meet these goals.*

I understand what case management services are available to me.*

Staff members provide referrals to me for resources that I may need.*

I understand there is a grievance process, if needed.*

Staff respects my confidentiality.*

If needed, staff provides me with resources and education on how to reduce risky behaviors.*

Staff members are able to answer questions that I have regarding the services that I receive.*

I am overall happy with the services that I receive from this agency.*

Provide the 3 services you receive from this agency and are most happy with.*

Provide at least one thing that could be improved by this agency.*

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