Input Survey WFT

Goodwill of Wayne and Holmes Counties, Inc.

Client Name*

Program*

Date*

Date

Write out any general suggestions you have that would help Goodwill improve our services

Please help us improve our services by answering the following questions:

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Orientation - Presenter was polite and respectful*

Orientation - I understood the information presented*

Orientation - The paperwork was easy to fill out*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Intake/ Service Plan - Case Manager was polite and respectful*

Intake/ Service Plan - I understood the information presented*

Intake/ Service Plan - The paperwork was easy to fill out*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Occupational Skills Program - I liked the options presented*

Occupational Skills Program - I understood the information presented*

Occupational Skills Program - The program enabled me to learn a marketable skill*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Training and Workshops - Presenter was polite and respectful ( if applicable)*

Training and Workshops - I understood the information presented*

Training and Workshops - The training classes will be or were helpful in getting a job*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Career Development and Service Plan - Case Manager was polite and respectful*

Career Development and Service Plan - I understood the information presented*

Career Development and Service Plan - The paperwork was easy to fill out*

Career Development and Service Plan - My Career Development Plan will help me obtain full time employment*

Career Development and Service Plan - My Case Manager helped me to define my goals and Research career options*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Work Experience - Site Supervisor was polite and respectful*

Work Experience - The worksite was clean and safe*

Work Experience - The skills program will be or was helpful in getting a job*

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Case Management - Case Manager was polite and respectful*

Case Management - My concerns were addressed in a timely manner*

Case Management - Goodwill made accommodations as necessary*

Case Management - I knew how to file a complaint*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Safety - I felt safe while at Goodwill*

Safety - The buildings and facilities were easy to navigate*

Safety - I knew what to do in an emergency*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

Counseling (put N/A if no applicable) - Counselors were polite and respectful*

Counseling (put N/A if no applicable) - Counseling helped or will help me get a job*

Comments

Rate the following areas 5=excellent, 4=above average, 3=good, 2= fair, 1=unsatisfied, 0=does not apply

GED Tutoring ASPIRE (Put N/A if Not Applicable) - Presenter was polite and respectful*

GED Tutoring ASPIRE (Put N/A if Not Applicable) - I understood the information presented*

GED Tutoring ASPIRE (Put N/A if Not Applicable) - The tutoring was helpful in passing the GED exams*

Comments