Stakeholder Satisfaction Survey Form

Rows	YES	NO
Does Premiere effectively address your concerns in a timely manner?
Are the Premiere counselors and/or staff available to collaborate with you in a timely manner?

How would you rate the quality of services being delivered on a scale of 1-5 with 5 being the highest?

	1	2	3	4	5

1 is Worst, 5 is Best

Rows	YES	NO
Is the Premiere referral process convenient and response time meeting your needs?
Is Premiere a dependable partner in providing community services?

Stakeholders