Is your consultant answering phone calls and e-mail messages in a timely manner?

Yes                     No  

Do you feel that the career path plan reflects the job goals of the person you support?

Yes                     No

On a scale of 1 to 10 (1 = Low/10 = High):

How do you rate your consultant on working with you?

Select 10 (Completely satisfied) 9 8 7 6 5 4 3 2 1 (Not Satisfied)

Overall, how satisfied are you with the services provided by Village Community Services?

Select 10 (Completely Satisfied) 9 8 7 6 5 4 3 2 1 (Not Satisfied)

Comments:

Optional: You may include your name below.

Your First Name                              Your Last Name

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