Customer Satisfaction Survery

The Board of Directors, Staff, and Funders of The Center for Independent Living are very interested in your feedback.  We'd like to know how we did!  Your ideas can help us improve our services.

* denotes a required field

Which Service(s) were you provided with? *
Please Select as many as applicable
Please Select One
Survey
Survey
Please mark all that are applicable
All of my expectations were met
The person who assisted me was courteous
The person who assisted me was knowledgable
I am better able to take care of myself
I am better able to access my home and/or community
My overall quality of life has improved
I am completely satisfied with how I was served
I would refer others to The CIL
If you would like you may include your personal information here
If you would like you may include your personal information here
This information will remain confidential.
Phone
Address