Agency Survey - JACKSON-VINTON COMMUNITY ACTION, INC.

JACKSON-VINTON COMMUNITY ACTION, INC.

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JVCAI AGENCY SURVEY

We would like to know what you think about our programs and services. Your feedback is very important to us and will be used to improve and/or expand our services. Thank you for your help!

Date Survey Completed *

Please list today's date.

OVERALL SATISFACTION

* Indicates required field

Overall, how satisfied are you with the services you received? Think about the people who helped you, the steps you went through, the length of time it took and the service itself. *

Very Satisfied Satisfied Neutral Unsatisfied Very Unsatisfied

Program you received services through *

Head Start WIC (Women Infants & Children Health Clinic Rent/utility assistance Transportation Emergency Repairs Weatherization/furnace repair None

What could we have done to increase your satisfaction? *

OUR PERFORMANCE - How did we do in the following areas?

The way the staff treated you. *

A - Excellent B - Good C - OK D - Poor F - Bad

Staff's knowledge about the service or program. *

A - Excellent B - Good C - OK D - Poor F - Bad

Staff's understanding of your needs. *

A - Excellent B - Good C - OK D - Poor F - Bad

The process to see if you qualify. *

A - Excellent B - Good C - OK D - Poor F - Bad

The length of time it took before you received help. *

A - Excellent B - Good C - OK D - Poor F - Bad

What could we have done to improve our performance?

Comment *

OTHER SERVICES

Were you told about other programs or services that would meet your's or your family's additional needs? *

Yes No, had no other need No, but had other needs

Please list the services you were told about. *

Did you experience any problems with the service(s) you received? *

Yes No

If you did experience any problems, please explain the problem. *

What other services have you participated in during the last six months? (check all that apply) *

Head Start WIC Health Clinic Utility Assistance Transporation Weatherization/furnace repair Emergency Repairs None

How did you hear aobut this program or service? Check all that apply *

Through a friend or relative Referred from another program or agency Received flier in the mail Read about it in newspaper Saw an add or flier At church or school

Is this the first time you have received this service through our agency? *

Yes No I have received other services, just not this one

What other services would you like JVCAI provide? Please be specific. *

Please include any other comments you would like us to know. *

THANK YOU FOR COMPLETING THE SURVEY!

Completing this portion is optional. However, if you would like us to contact you in regards to the survey you have listed you must provide your contact information.

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Can We Contact You Via Texting? *

Yes No

Please List the Best Way to Reach You. *

Best Time to Reach You (please check all that apply). *

Morning Afternoon Any

Primary Phone Number *

Cell Phone Number *

Submit

Jackson-Vinton Community Action, Inc.
118 S. New York Avenue
Wellston, Ohio 45692

PROVIDING SERVICES TO JACKSON AND VINTON COUNTIES

Visit us on Facebook

Hours

Monday-Friday:
8:00 am - 4:30 pm

Telephone

740-384-3722
1-800-686-4339

Email Executive Director

[email protected] Molly Seimetz

Home
Job Postings
Information on JVCAI >
Programs and Services >
Forms
Links
Board Members
Surveys >
- Agency Survey