|
Header - Survey Questions:
|
Header Section - #95B3D7 |
|
Q1 *
| Describe your level of satisfaction with the Independent Living Program (ILP). |
|
Q2 *
| Is your family member treated respectfully by ILP staff? |
|
Header - Optional Questions:
|
Header Section - #95B3D7 |
|
Your Name (Optional)
|
If you wish to have your name entered in the draw to win a $50 Gift Card to Cottonwood Mall please include your name! |
|
Individual Supported by CSCL
|
|
|
Relation
| Please record the relation of the person completing survey. |
|
Service
| |
|
Follow Up?
| Is an immediate follow-up required by CSCL? |