Survey | Review Creative Concepts for Living's services.

7125 North Lindbergh
Hazelwood, MO 63042
Tel: (314) 731-0075
Fax: (314) 731-0080

Family Member, Advocate, Funder Feedback Survey

We truly appreciate your feedback and input about Creative Concepts for Living and how we can better serve you and your family.

If you're a family member, advocate, or funder please complete the survey below. Please note that this form will only be seen by the Executive Director.

All of the questions are required unless otherwise noted. If you would prefer to print the form, download the PDF.

Full Name:	(optional)
E-mail:	(optional, but required to receive a copy of this form)
Telephone (with area code):	(optional, but required for a return phone call)

	Strongly Agree	Agree	Not Sure or N/A	Disagree	Strongly Disagree
I can easily access the members of the support team.
The support staff treats me with respect and I'm comfortable when I go to the home.
My family member, who is supported by CCL, gets out in the community enough.
My family member is working on their goals.
The Support Coordinator responds to me in a timely manner.
The Support Staff are adequately trained.
I'm pleased with the condition of the home.
I'm pleased with the condition of the van (if applicable). (optional)
I'm pleased with the medical care my family member receives.
The funds are appropriately tracked.
The CCL activities (picnic and holiday gatherings) are enjoyable.
My family member is happy.
I'd like to recognize these staff for doing an outstanding job: (optional)
I believe these staff need additional training: (optional)
I would be willing to contribute the following skills, interests, or hobbies with CCL: (optional)
I like these things about CCL: (optional)
If it were up to me these are things I would change about CCL: (optional)
I would like a return call to discuss something specific: (optional)	Yes	No
If yes, I would like to discuss: (optional)
Additional comments or concerns: (optional)
Spam protection - the color of grass in the summer is: