Client Surveys

Meals Survey

1. Your Name(required)
2. Email(valid email required)
3. What services are you receiving? Home Delivered Meals Congregate Sites Restaurants Other
4. Is there enough variety in the Menu? Yes No Sometimes
5. Does the food taste good? Yes No
6. If you receive Meals on Wheels is your driver friendly and courteous? Yes No Other
7. If you visit a Congregate Site, is the site manager friendly and helpful? Yes No Other
8. If you participate in the Restaurant Program, is the restaurant staff friendly and courteous? Yes No Other
9. How is the temprature of your food? Hot when it is suppose to be? Cold when it is suppose to be?
10. Is the Quality of the food good? Yes No
11. Are you comfortable with the level of your contribution? Yes No Other
12. Have your services been conistent? Yes No
13. Do you have any additional needs that are not been met at this time? Yes No
14. Do you have any suggestions for the improvement of the program?
15. Thank you for taking the time to fill out this survey. We appreciate your help and suggestions.
16. If you have any questions please call 269-279-8083 or 1-800-641-9899

 

cforms contact form by delicious:days

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