Kitimat CDC Satisfaction Survey Form
The Kitimat CDC strives for inclusive, family-centered services. We welcome all of your feedback in order to help us improve our work. Your identity and information is treated confidentially.
What programs did you receive service(s) from?
Healthy Babies Program
Building Blocks Program
Infant Development Program
Family Fun spot
Physiotherapy
Social Emotional Wellness program
Behavior Consultation & Intervention Services
Out of School Care Program
Parent Support Program
Family Preservation Program
Family Support Program
Speech Language Pathology
Occupational Therapy
Prenatal Classes
Life Skills Classes
Supported Child Development Program
Youth Transition Program
Preschool Services
Daycare Services
Child & Youth with Support Needs(CYSN) Program
Housing Support Program
Better at Home Program
Poverty Law Advocate
Did you feel welcomed by Staff?
1
2
3
4
5
Strongly disagree - 1 star, Disagree - 2 stars, Neutral - 3 stars, Agree - 4 stars, Strongly agree - 5 stars
Feedback Welcome
Were the services you wanted available?
1
2
3
4
5
Strongly disagree - 1 star, Disagree - 2 stars, Neutral - 3 stars, Agree - 4 stars, Strongly agree - 5 stars
Feedback Welcome
Did you feel you had input into the service(s) you received?
1
2
3
4
5
Strongly disagree - 1 star, Disagree - 2 stars, Neutral - 3 stars, Agree - 4 stars, Strongly agree - 5 stars
Feedback Welcome
Overall, did you feel satisfied with the service(s) you received?
1
2
3
4
5
Strongly disagree - 1 star, Disagree - 2 stars, Neutral - 3 stars, Agree - 4 stars, Strongly agree - 5 stars
Feedback Welcome
Contact Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Submit
Should be Empty: