Satisfaction and Interest Survey
The Clinton County Board of Developmental disabilities strives to provide you or the individual you care for with the best possible services. We would like to know how we are doing currently so that we can continue to develop services and offerings important to you.
Who is completing this survey?
*
Person receiving services
Parent/Guardian/Family Member
Paid Provider
Prefer not to answer
What services do you or your family receive from CCBDD? (Check all that apply.)
*
Community Integration
Early Intervention
Educational/School Age
Employment First
Family Support Services
Residential/Housing/Supported Living
Service and Support Administration
Special Olympics
Unsure
What services do you or your family receive from CCBDD (Check all that apply)
*
Community Integration
Early Intervention
Educational/School Age
Employment First
Family Support Services
Residential/Housing/Supported Living
Service and Support Administration
Special Olympics
Unsure
Are CCBDD staff understanding of your needs or the needs of the individual you care for?
Yes
No
If no, please explain:
Are CCBDD services meeting your needs or the needs of the individual you care for?
Yes
No
If no, please explain how we could do better:
How do you currently receive information about CCBDD services or events?
Email
Facebook-Clinton County Board of DD
CCBDD website
Facebook-Early Intervention
One Call Now
Mail
How do you currently receive information about CCBDD services or events?
*
Email
Facebook-Clinton County Board of DD
CCBDD website
Facebook-Early Intervention
One Call Now
Mail
How could we communicate better?
We plan to distribute a newsletter via email and will collect your email address below.
What information sessions or activities are you interested in?
Advocacy and Rights
CCBDD services overview
Employment
Health and Nutrition
Housing/Supported Living
IEP/School Supports
IFSP/ISP
Recreation/Socializing
Safety
Technology
Waivers
Parent Support Group
Volunteering
What information sessions or activities are you interested in?
Advocacy and Rights
CCBDD services overview
Employment
Health and Nutrition
Housing/Supported Living
IEP/School Supports
IFSP/ISP
Recreation/Socializing
Safety
Technology
Waivers
Parent Support Group
Volunteering
What other topics are of interest to you?
What else should we know?
Please provide your email address to receive newsletters and information:
example@example.com
OPTIONAL: Please provide your name and phone number if you want to be contacted regarding your responses to this survey:
First Name
Last Name
Phone Number
Please enter a valid phone number.
Thank you
We thank you for taking the time to help us provide better services!
Submit
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