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Client Satisfaction Survey

The purpose of this survey is to improve our services to our clients. We would appreciate your thoughts and comments.

"*" indicates required fields

Date * Required

Month

Day

Year

Your Name (optional)

First/Primer Last

Service Request ID Number (optional)

Name of DRTx staff person who handled your case. * Required

First/Primer Last

Do you think we responded to your request for help in a timely way?

Yes

No

Was the person taking your request for services (intake) polite and helpful?

Yes

No

Did the person handling your case explain to you what he or she could do to assist you?

Yes

No

Did the person handling your case keep you informed about your case?

Yes

No

Was the person handling your case polite and professional?

Yes

No

Was your problem resolved?

Yes

No

Would you recommend our services to others?

Yes

No

Did you find information on our website helpful?

Yes

No

Didn't use the website

How was the service you received from the person handling your case?

Very Good

Good

Not Good

How was your overall experience with Disability Rights Texas?

Very Good

Good

Not Good

Please provide comments or suggestions about our services.

Share Your Story * Required

Throughout the year we share client stories in our newsletters, social media and website. Would you be interested in speaking with someone about sharing your story so others can learn about the services that DRTx provides?

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Phone Number * Required

Email Address * Required

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