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Tell Us What You Think...
Client Feedback Questionnaire

Do you now or have you previously received services from Solid Ground? Please complete this short survey if you have used one or more of our programs. ALL of the questions in this survey are OPTIONAL, and you don't need to give us your name unless you want to. Your answers will only be shared internally with Solid Ground staff with the goal of improving our services. You can also ask for more information if you are interested in joining our client Advisory Council.
Your name (optional):

Which programs or services did you receive at Solid Ground? Please list all that apply:

On a scale of 1 (low) to 5 (high), do you feel that you were treated respectfully by staff?
  Least Respectful Average Most Respectful 
Treatment Comments

On a scale of 1 (low) to 5 (high), did you receive services appropriate to your needs?
  Least Appropriate Average Most Appropriate 
Appropriate Services Comments

On a scale of 1 (low) to 5 (high), how would you rank staff’s understanding and respect of your culture?
  Worst Understanding Average Best Understanding 
Culture Respect Comments

On a scale of 1 (low) to 5 (high), did staff listen to your concerns and ideas?
  Never Average All the Time 
Listening Concerns Comments

Were you provided an interpreter if needed?
What language do you speak in your household?

What challenges did you face, if any, in accessing our services? (Transportation, time and location, etc.)

How do you think we could improve our services? What would you keep the same?

Are you interested in joining our client Advisory Council to provide regular feedback to Solid Ground? If yes, please fill in your name and phone number, email and/or mailing address below.


Phone Number:

Email Address:

Mailing Address:

On a scale of 1 (low) to 5 (high), how would you rate the services that you received at Solid Ground?
  Worst Average Best 
Services Received Comments

Would you recommend Solid Ground to others?
Please share with us any final comments about your experience at Solid Ground.

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