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Family Satisfaction Survey

* is a required field

  Today's Date*  
  The transportation I requested was initiated within a satisfactory time period.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  I know whom to contact at Community Care-A-Vans when I have a question.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  My contact is easily accessible to me.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  IMy contact provides me with timely information.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  I am satisfied with how the driver communicated information about my family member with me.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  I am satisfied with the rest of the company’s staff/services.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  I am satisfied with the program’s environment (vehicle)*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  This program responds to my urgent or emergency needs.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  Overall I am satisfied with the program.*   Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
  What do we do well, and how can we do a better job for you?*  
     

 

 
Community Care-A-Vans, 50 Walton St.Attleboro, MA 02703, Phone: 508-223-1672
Copyright 2006 Community Care-A-Vans