Extended Families Participant Satisfaction Survey

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Before you begin, please select your preferred language in the top right corner.

Trước khi bắt đầu, vui lòng chọn ngôn ngữ ưa thích của bạn ở góc phải phía trên.

在开始之前，请在右上角选择您的首选语言。
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Thank you for taking the time to complete this short survey! It will only take a few moments of your time and may make the world of difference to you or someone we support.
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Your Feedback is Important

We want to partner with you to co-design our services!

Sharing your insights will help us understand what we are doing well and where we can do better.
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This will help us to:

Identify areas of strength and excellence within our services.

Address any challenges or concerns you may have encountered.

Make positive changes based on your suggestions and preferences.
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Please select which services you use with Extended Families.* This field is required.
Plan Management
Support Workers (LinC)
Support Coordination
Social and Capacity Building Groups (Vuon Len, Tham Gia, Ket Noi, etc.)
ExtendABLE
My Time
Rebalance (Support for carers)
Other
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Overall Satisfaction* This field is required.Rate your overall satisfaction with Extended Families.
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Communication* This field is required.How satisfied are you with our communication?
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Service Quality* This field is required.How satisfied are you with our service quality?
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Timeliness* This field is required.How satisfied are you with the timeliness of our services?
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Staff Courtesy* This field is required.How satisfied are you with the courtesy and professionalism of our staff?
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Understanding Your Needs* This field is required.How satisfied are you that we understand and meet your specific needs?
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Accessibility* This field is required.How satisfied are you that our services are accessible and available in the language and mode of communication that you prefer?
Very Satisfied
Satisfied
Neither Satisfied or Unsatisfied
Somewhat Unsatisfied
Not at all Satisfied
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Very Satisfied
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Satisfied
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Neither Satisfied or Unsatisfied
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Somewhat Unsatisfied
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Not at all Satisfied
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Lastly!

Extended Families' Mission is:

To work in partnership with people with disabilities and their families to achieve outcomes they value through building strengths, developing skills and creating meaningful community connections.
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Do our services support you (or someone you support) to build on strengths, develop skills or create meaningful community connections?* This field is required.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
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Strongly Agree
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Agree
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Neutral
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Disagree
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Strongly Disagree
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Additional CommentsPlease share any specific feedback, suggestions or comments about our services. We appreciate your detailed feedback.
Huge
Large
Normal
Small
Ok
Ok
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Would you recommend Extended Families to others?
YESNO
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Contact Information (Optional)Would you like us to follow up with you regarding your feedback? Click YES to add your contact details on the next page.
YESNO
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Name
First Name
Last Name
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What is your preferred method of contact?You can select more than one.
Phone call
Email
SMS
Other
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EmailYou can leave blank if phone is preferred
example@example.com
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Phone NumberYou can leave blank if email is preferred
Should be Empty: