Customer Service Satisfaction Survey
The Aya Center is committed to providing respectful, responsive, accessible, and person-centered services. This survey allows us to evaluate your experience, identify opportunities for improvement, and strengthen the quality of services we provide. Your feedback will be reviewed as part of our ongoing Quality Improvement (QI) efforts. Please answer each question honestly. Your responses will be used to improve our services and customer experience.
Relations ship to The Aya Center:
Client/Consumer
Parent/Guardian
Family Member
Referral Source
Community Partner
Other
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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I was treated with respect and dignity.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Staff were courteous and professional.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Staff listened to my questions, concerns, and needs.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Staff returned calls, messages, or other communications in a reasonable timeframe.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I received accurate and helpful information.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Staff demonstrated knowledge of the services available to me.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Staff made me feel comfortable asking questions or expressing concerns.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I feel that my needs and preferences are taken seriously.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
The services I receive are helping me work toward my goals.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I feel safe when receiving services from The Aya Center.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I understand my rights as a person receiving services.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Overall, I am satisfied with The Aya Center.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
The Aya Center meets my expectations for customer service.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
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Have you experienced any concerns, delays, communication problems, or difficulties accessing services?
No
Yes
If yes, please explain:
Were your concerns addressed in a timely and satisfactory manner?
Yes
No
Not Applicable
Please explain if needed:
What do you like most about the services or customer service provided by The Aya Center?
Would you recommend The Aya Center to others?
Definitely
Probably
Unsure
Probably Not
Definitely Not
What could The Aya Center do better?
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THANK YOU!
Thank you for taking the time to provide feedback. The Aya Center values your input and uses customer and stakeholder feedback to identify strengths, address concerns, and support continuous improvement in the quality, accessibility, and effectiveness of our services.
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