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  • Aging and Disability Resource Connection (ADRC) of Oregon Satisfaction Survey

    This is a monthly survey sent or made available online to participants of CAPECO's ADRC clients to gather input about their level of satisfaction with services offered and rendered through the program.
  • Date:*
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  • We appreciate hearing your valuable input. Please continue, to complete this survey.

  • 2. Did you get the information you needed (select one)?*
  • 3. Please rate the quality of your interaction with CAPECO staff, from 1 to 4, with 1 = not at all friendly or helpful, 2 = Somewhat friendly or helpful, 3 = Friendly or helpful or 4 = Very friendly and helpful. Select one option below to indicate your staff interaction quality score.*
  • 4. Rate the ease of using ADRC (1 to 4, not at all easy to use, to very easy to use) Select one option below.*
  • 5. Was the ADRC call line answered by a person (choose one)?*
  • 6. Did you leave a voice mail (choose one)?*
  • 7. If you left a voice mail, rate your experience in their calling you back (1 to 4, from 1. took too long to call back, to 4. called back sooner than expected).
  • 8. Would you recommend calling ADRC to friends and family? Select response below.*
  • 9. Do you feel that the resources ADRC staff referred you to improved your physical health? Choose one below.*
  • 10. Do you feel that the resources ADRC staff referred you to improved your mental health? Choose one below.*
  • 11. If you are a person living with disabilities, do you feel that the resources ADRC staff referred you to allowed you to maintain an independent living situation? Choose one, below.
  • 12. If you are a person living with chronic illness, do you feel that the resources ADRC staff referred you to allowed you to maintain an independent living situation? Choose one below.

  • If you have questions or need assistance completing this survey, please call:

    Main Office - 541-276-1926

    Local ADRC Number - 855-673-2372, enter zip code when prompted

     

    Thank you! Your responses will help us improve our services and will be used to shape future Area Plans to aid seniors.

     

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