IFP Client Satisfaction Survey Intensive Family Preservation Client Satisfaction Survey Name* First Last Date* MM slash DD slash YYYY Please select the response that best reflects your level of satisfaction.1. This program was fully explained to my family during the first session:* Strongly agree Agree Disagree Strongly Disagree Does not apply 2. Home visits occurred at times that were convenient to my family:* Strongly agree Agree Disagree Strongly disagree Does not apply 3. Staff were professional and polite to my family:* Strongly agree Agree Disagree Strongly disagree Does not apply 4. I was involved in developing service goals:* Strongly agree Agree Disagree Strongly disagree Does not apply 5. Staff respected my culture/ethnic:* Strongly agree Agree Disagree Strongly disagree Does not apply 6. Staff listened to my concerns:* Strongly agree Agree Disagree Strongly disagree Does not apply 7. Number of hours spent with staff met our needs:* Strongly agree Agree Disagree Strongly disagree Does not apply 8. Overall, I was satisfied with services received:* Strongly agree Agree Disagree Strongly disagree Does not apply 9.There has been improvement in the problems we sought help for:* Strongly agree Agree Disagree Strongly disagree Does not apply 10. We are better able to continue working out problems on our own:* Strongly agree Agree Disagree Strongly disagree Does not apply 11. We know how to access community resources to help meet our family’s needs:* Strongly agree Agree Disagree Strongly disagree Does not apply 12. My parenting skills have improved:* Strongly agree Agree Disagree Strongly disagree Does not apply 13. If we need help in the future, we are likely to request IFP:* Strongly agree Agree Disagree Strongly disagree Does not apply 14. I know people who will listen and understand me when I need to talk:* Strongly agree Agree Disagree Strongly disagree Does not apply 15. I have people I am comfortable talking to about my child’s problems:* Strongly agree Agree Disagree Strongly disagree Does not apply 16. In a crisis, I would have the support I need from family or friends:* Strongly agree Agree Disagree Strongly disagree Does not apply 17. I have people with whom I can do enjoyable things:* Strongly agree Agree Disagree Strongly disagree Does not apply 18. I feel like my family has increased supports (formal and/or informal):* Strong agree Agree Disagree Strongly disagree Does not apply 19. Comments:
