Mental Health Association of Franklin County

Ombudsman Client Satisfaction Survey

The purpose of this survey is to evaluate the Ombudsman services you received. Your input is important in insuring that clients receive the best care possible. Thank you for taking the time to respond to these questions. Your response will be anonymous unless you choose to give us your name.

Name (optional):
Date:
Agency(s) client is involved in:

Please check the responses (below) that best reflects your opinion:
The Ombudsman responded to my initial contact in a reasonable time period.
Strongly Agree     Strongly Disagree Not Applicable
The Ombudsman treated me with respect.
Strongly Agree     Strongly Disagree Not Applicable
My problem was resolved due to the help I received from the Ombudsman.
Strongly Agree     Strongly Disagree Not Applicable
The Ombudsman acted in a fair and impartial manner in advocating for me.
Strongly Agree     Strongly Disagree Not Applicable
I am satisfied with how my concern was resolved.
Strongly Agree     Strongly Disagree Not Applicable
I would use the services of the Ombudsman again.
Strongly Agree     Strongly Disagree Not Applicable
How did you learn of the Ombudsman services?
What recommendations do you have regarding the Ombudsman position?