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ECI Participant Satisfaction Survey
TO BE FILLED OUT BY ENDEPENDENCE CENTER PARTICIPANTS ONLY
The purpose of the survey is to gather information about your experience at ECI.
If you need help filling out the survey online, call Rena Lewis at ECI at 351-1578. The Consumer Advisory Committee (CAC) can also assist you.
CLICK THE ANSWER
*How long received services at ECI.
0-5 years
6-10 years
more than 10 years
Select one
*What is your disability?
*Are you pleased with services from ECI?
YES
NO
*Are you treated with respect by staff?
YES
NO
ECI SERVICES USED
*Information and Referral
YES
NO
*Was the Information & Referral helpful?
YES
NO
*Peer Mentoring
YES
NO
*Was the Peer Mentoring helpful?
YES
NO
*Housing Information
YES
NO
*Was the Housing Information helpful?
YES
NO
*Advocacy
YES
NO
*Was the Advocacy helpful?
YES
NO
*Independent Living Skills (ILS) Training
YES
NO
(budgeting, etc.)
*Were the ILS Trainings helpful?
YES
NO
*Workshops
YES
NO
(webinars, ADA, etc.)
*Were the Workshops helpful?
YES
NO
*Support Group
YES
NO
(IL Group, etc.)
*Was the Support Group helpful?
YES
NO
*SS Work Incentives Counseling
YES
NO
*Was SS Work Incentives Couns. helpful?
YES
NO
*Services for Deaf/Hard of Hearing
YES
NO
*Was the Deaf/Hard of Hearing helpful?
YES
NO
*Were the Medicaid Services helpful?
YES
NO
*Medicaid Services
YES
NO
INFORMATION MEDIA USED
*Have you used ECI website?
YES
NO
*Was the website helpful?
YES
NO
*Have you used ECI Facebook Page?
YES
NO
*Was the Facebook Page helpful?
YES
NO
*Have you used ECI Newsletter/Calendar?
YES
NO
*Was the newsletter/calendar helpful?
YES
NO
ADDITIONAL INFORMATION
What additional Services would you like at ECI that are not offered at this time?
What are your ideas for workshop topics?
What other comments or ideas do you have?
THANK YOU!
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