T.E.A.M. Habilitation & Respite

Train, Enrich, Accommodate, Mainstream

Client Satisfaction Survey

We aspire to continually maintain open communication with our Clients. Our Client Families have the insight and awareness we seek to structure this agencies policies and procedures. Your input also ensures we are always providing the highest quality of service. Your time completing this survey is greatly appreciated.

*Name : Type of Service Receiving *Satisfaction with Service Transparency of Administration Agencies Relationship to your Child Provider's Name (Optional) Provider's Personality
Excellent
Very Good
Good
Fair
Poor
Very Poor
Provider's Level of Skill Provider's Knowledge Base How does the provider interact with your child Does Provider arrive on time Does Provider keep area neat Hows does Provider interact with family
Provider interacts to the level we desire
Provider does not interact with the family
We would like the Provider to interact more
We would like the Provider to interact less
Does Provider respect cultural/religious differences How does your child interact with Provider Does Provider come prepared Any additional comments or concerns regarding your provider
Would you like us to share this information with your Provider Do you feel the agency provides support to your Provider Are you aware of the teaching and training resource available to you as a family and community Additional Comments

Privacy Policy

T.E.A.M. Habilitation & Respite does not disclose personal or health information to unaffiliated third parties. We follow HIPPA and all Federal Laws regarding Personal, Private, Health Information. If you have any questions or concerns about the T.E.A.M. Habilitation & Respite’s Privacy Policy or its implementation, you may contact us at (480) 816-1866.