IPV FAIR Client Satisfaction Survey (rev 20200616) IPV FAIR Client Satisfaction Survey rev 2020-06-16 IPV FAIR Client Satisfaction SurveyName* First Last Date* MM slash DD slash YYYY Please help us improve our program by answering some questions about the services you have received. We are interested in your honest opinion, whether they are positive or negative. Please answer all of the questions. We also welcome your comments and suggestions. Thank you very much, we really appreciate your helpWhat is your sex?* Female Male 1. How would you rate the quality of service you received from your clinician?* Excellent Good Fair Poor 2. How would you rate the quality of service you received from your Family Navigator?* Excellent Good Fair Poor Did not meet with Navigator 3. To what extent has this program met your needs?* Almost all Most A few None 4. To what extent has this program met your child(ren)'s needs?* Almost all Most A few None Child(ren) did not meet with Navigator or Clinician 5. Have you noticed any positive changes in your child(ren)'s behavior as a result of this program?* Definitely yes Mostly yes Unsure Mostly not Definitely not My child(ren) did not partcipate 6. To what extent has this program met your partner's needs?* Almost all Most A few None My partner did not participate 7. Have you noticed any positive changes in your partner's behavior as a result of this program?* Definitely yes Mostly yes Unsure Mostly not Definitely not My partner did not participate 8. How satisfied are you with the amount of help you received?* Very satisfied Mostly satisfied Mildly dissatisfied Quite dissastisfied 9. Have the services you received helped you to deal more effectively with your concerns/problems?* Helped a great deal Helped somewhat Really didn’t help Seemed to make things worse 10. If a friend or family member needed help, would you recommend the program?* Definitely yes Yes Maybe No Definitely not 11. If you were to seek or need help again, would you come back to the program?* Definitely yes Yes Maybe No Definitely not 12. How did you feel about the length of the program?* Way too short A little too short Just right A little too long Way too long How helpful were the following aspects of the progam:1. Individual sessions with my therapist* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or part of my treatment 2. Help from the Family Navigator* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 3.Getting connected to another service/program for myself or my child(ren)* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 4. Developing a safety plan for me and my family* Very helpful Helpful neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 5. Talking about my parents/family background with my therapist* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 6. Discussing my role as a parent* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 7. Practicing communication skills* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 8. learning relaxation/coping strategies* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 9. Identifying my triggers and how to handle them* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 10. Reducing my aggression/conflict with partner* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 11. Providing me with parenting skills* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 12. Helping me to understand my child(ren)* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 13. Helping me to communicate with my coparent* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment 14. Improving my relationship with my children* Very helpful Helpful Neither helpful or unhelpful Unhelpful Very unhelpful Not applicable or not part of my treatment In your words, please tell us what you liked most about the program.In your words, please tell us what you liked least about the program?Do you have any suggestions for how to improve the program?
