Living Resources
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Our Mission is to promote and provide life
enhancing services to individuals with disabilities
in a safe and secure environment.

300 Washington Avenue Extension
Albany, New York  12203
518-218-0000  (fax)518-862-2175

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View A  Living Resources Video!
(7 minutes)

2008 Family Survey

FAMILY SATISFACTION SURVEY
2008

Please answer all questions, adding any comments you'd like to make in the spaces provided.
The information on your report will be used to evaluate the quality of our 
services that your loved one receives.

Program Name or Residential Address:  (if more than one service, please list all here)

Name of Individual Served (optional):


Please choose excellent, good, fair, poor or I don't know to answer the questions below:
1. Note your opinion of the program's environment (location, facility condition, furniture, etc.)
Any comments about Question #1?
2. Note your satisfaction with the responsiveness of the program staff to any issues/concerns you have raised.
Any comments about Question #2?
3. Note your satisfaction with the management of this program.
Any comments about Question #3?
4. Note your satisfaction with staff members and how they are responding to the needs of your loved one.
Any comments about Question #4?
5. How would you rate the overall quality of this program?
Any comments on Question #5?
7. Do you know whom to contact if you have a problem 
with this agency?		 Yes No
8. Would you recommend this program/
service to others?		 Yes No
9. Overall, has this program improved the 
quality of your loved ones life?		 Yes No
10. Have services improved for your
family member since last year?		 Yes No
11. Are you familiar with the Living Resources website?
(www.livingresources.org)		 Yes No
12. Do you know how to e-mail the CEO through the website? 
(On the website, click on CEO's Address, then at bottom right,
click on mail icon.)?		 Yes No

Please give your answers to the following questions by filling in the box provided
What do you like most about this program?

Are there any aspects of the program that need improvement?

Do you have any suggestions on ways to better communicate with families?:

 

IDEAS TO IMPROVE COMMUNICATION - PLEASE JOIN US!
We are interested in hosting a series of family nights with key staff on a quarterly basis in each county.  Would you be interested in being notified about such meetings?

Yes                   No
Please list any topics you would like covered:

Topics:    

  
   
Please indicate time preference:                                  Day           Evening
 
Would you like to talk more about your experiences with this program, or do you have any specific questions or concerns you would like answered?             

Yes                    No
If you answered yes to the above question, please be sure to leave your name and phone number below:

Name:   

Phone #:       

 
Please share any additional comments you may have, below:

 
 
Submitted By: (optional)

Name:   
Email:    

Day Phone#:         

Night Phone #:      

 

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