Consumer Satisfaction Questionnaire

Please take a moment to fill out our survey!
We definately appreciate your feedback.

Consumer/Intern

Contact Person

Date

FUCIS Contact

We would be grateful if you could spare a few minutes to complete this Consumer Satisfaction Questionnaire to help us ensure that our standard and consumer satisfaction exceeds expectations whenever possible. Please tick the appropriate box to indicate your degree of satisfaction.1= Excellent 2 = Good 3 = Satisfactory 4 = Poor

Topic

1|2|3|4

Comments / Suggestions

How do you rate our professionalism in dealing with you?

Select

If you receive any technical support, how do you rate the technical competence of our staff?

Select

How well do you have opportunities to provide feedback on the performance of staff that support you?

Select

How well do you have opportunities for communication with staff that support you on a regular and timely basis?

Select

How well does your staff provide effective methods to assist you in exploring your job interests?

Select

How well have you been supported to work in integrated job settings?

Select

How would you rate staff in working closely with you in planning, identifying, and developing your job goals and support needs?

Select

How would you rate how well you and family have been encouraged and supported to understand the benefits of integrated employment?

Select

How well would your rate your Staff in supporting you to obtain employment that matches your skills and interests?

Select

How well or if any have accommodations and adjustments are made to enable you to perform your job functions?

Select

How do you rate staff clearly explaining to you employee benefits and rights?

Select

How would you rate employers giving you feedback on your performance?

Select

How would you rate being supported to explore your personal interest and options for community involvement, personal interest, and hobbies?

Select

How much are you involved in activities that connect you to other non-disabled people in the community?

Select

How well do you rate your decision making of what to do during the day on a regular basis?

Select

Do you have any comments or suggestions that would help us improve our quality of customer service?

Select

What do you like about FUCIS?

Select

What do you dislike about FUCIS?

Select

How well do you think we understand your employment needs?

Select

What would we need to do to satisfy your requirements even more?

Select

Would you be prepared to recommend FUCIS to others?

Select

Would you be prepared to provide a statement for use in our literature and or Website?

Select

Your positive action combined with positive thinking results in success.

810 E Pico Blvd, Suite 225

1-323-633-9124

Mon - Fri: 9:00 - 5:00

Consumer Satisfaction Questionnaire

Please take a moment to fill out our survey!
We definately appreciate your feedback.

Your positive action combined with positive thinking results in success.

Need help? Call our intake team 24/7 at (323) 633-9124

CONTACT US TODAY

Email Us…

For Any Enquiries

Please Leave a Message Below

We Are Here For You

810 E Pico Blvd, Suite 225

1-323-633-9124

Mon - Fri: 9:00 - 5:00

Consumer Satisfaction Questionnaire

Please take a moment to fill out our survey! We definately appreciate your feedback.

Your positive action combined with positive thinking results in success.

Need help? Call our intake team 24/7 at (323) 633-9124

CONTACT US TODAY

Email Us…

FUCIS Site Links

Vendor#: PD4151 Service Code: 055

For Any Enquiries

Please Leave a Message Below

We Are Here For You

Please take a moment to fill out our survey!
We definately appreciate your feedback.