Community Stakeholder Survey

As a service provider in our community, your feedback on the services we provide at Intersect Youth & Family Services is important. We use this information to find out how our services are supporting the community, to identify areas that we can improve on and to guide our future planning.

Please note that:

  • You do not have to participate in this survey if you don’t want to.
  • Your responses are anonymous and confidential; your name is not attached to the survey.
  • This survey takes about 5 minutes to complete.


Please fill out as much information as possible.


Physician
Health Authority
Social Service
School District
Other:
We make referrals to your agency.
You make referrals to our agency.
We share mutual clients.
Other:
We make referrals to your agency
You make referrals to our agency
We share mutual clients
We attend community meetings together
We participated in a community response together
We have attended training together
Other:
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Strongly Disagree Disagree Agree Strongly Agree N/A
Very Dissatisfied Dissatisfied Satisfied Very Satisfied N/A
Very Dissatisfied Dissatisfied Satisfied Very Satisfied N/A
Very Dissatisfied Dissatisfied Satisfied Very Satisfied N/A
Very Dissatisfied Dissatisfied Satisfied Very Satisfied N/A
Very Dissatisfied Dissatisfied Satisfied Very Satisfied N/A








Important: Click the "I'm not a robot" checkbox above, before clicking the 'SEND' button.