Client Satisfaction Survey Did the assessor clearly explain the nature and purpose of today’s assessment?(Required) Yes No Please ExplainDid the assessor conduct himself/herself in a professional manner?(Required) Yes No Please ExplainWere you provided with the opportunity to present all of your concerns and respond to all questions from the assessor during the assessment?(Required) Yes No Please ExplainPrior to this assessment did you receive a reminder call?(Required) Yes No If transportation services were arranged to get you to and from the assessment were they on time and courteous?(Required) Yes No No Transportation Service Required Please ExplainIf interpreter services were used during your assessment were they effective in assisting you to communicate with the assessor?(Required) Yes No No Interpreter Services Required Please ExplainDo you feel that you have had adequate information provided to you to accurately conclude your assessment opinion?(Required) Yes No If you wish to be contacted by a member of management regarding any feedback you may have and/or to lay a formal complaint, please indicate “YES” and complete the following section:(Required) Yes No Date of Assessment(Required) MM slash DD slash YYYY Assessor Name(Required)Your Name First Last Your Email
