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Partnership Referral from a Former Client Organization
Member Perk - Experience Satisfaction Review
Did you use an Atlas Free Network Member Perk? Please take a few minutes to share your experience. You may remain anonymous or choose not to fill out this form if you do not feel comfortable sharing your experiences. If you have any questions please reach out to membership@atlsafree.org.
Name
First
Last
This is not required, you may remain completely anonymous.
What organization do you represent?
This is not required, you may remain completely anonymous.
Can we follow up with you after this survey if necessary?
Yes
No
If yes, please write in the best way to contact for any follow-up questions:
Member Perk you participated in:
(Required)
What month/year did you complete the service?
Open-Ended Questions
Did this provider's orientation to services adequately explain the experience?
If you could change one thing about the program or give leadership one suggestion for improvement, what would it be?
Please Score 1-5
On a scale with 1 being strongly disagree and 5 being strongly agree.
I am satisfied with the services I received from this provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
I would come back to this provider if I needed help again.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
I would recommend this provider to other organizations in my network.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
This provider offered referrals to other organizations or services.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
My organization has improved programmatically because of the provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
My organization has improved operationally because of the provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
My organization has improved financially because of the provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
[my_acf_user_form field_group="12979"]
