Satisfaction Survey

Recently you received services from Disability Rights Oregon. Please take a few minutes to complete this short survey. Your answers to the questions below will help us evaluate the quality of our services.

Name

Nombre

First Name

Last Name

Email

El Email

Address

¿Cuál es su domicilio?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Were you satisfied with the services provided by our staff?

¿Estuviste satisfecho con los servicios proporcionados por nuestro personal?

Very satisfied (Muy satisfecho)

Somewhat satisfied (Algo satisfecho)

Not satisfied (No satisfecho)

What did you like about the services you received from us?

¿Qué te gustó de los servicios que recibiste de nosotros?

What changes could we make to better serve you in the future?

¿Qué cambios podríamos hacer para servirte mejor en el futuro?

Would you contact us again if you needed information or assistance?

¿Sí necesitaras información o asistencia, volverías a ponerte en contacto con nosotros?

Was the problem we helped you with successfully resolved?

¿El problema con el que te ayudamos se resolvió exitosamente?

Successful (Exitosamente)

Partly successful (Parcialmente)

Unsuccessful (No se resolvió)

Is there anything else you would like us to know about the services you received from us?

¿Hay algo más que quisieras que sepamos acerca de los servicios que recibiste de nosotros?

What was the name of the person who assisted you?

¿Cómo se llama la persona que te dio asistencia?

The services provided by this program helped me make informed choices about my situation.

Los servicios proporcionados por este programa me ayudaron a tomar decisiones informadas sobre mi situación.

Yes ( Sí)

No

Somewhat (Un poco)

Satisfaction Survey

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Hours

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