Satisfaction Survey

We appreciate your time and opinion and we will keep your information private.

Your Name: (optional)
 Discharge Date:
Job Coach/Placement Specialist:


 Email Address: (optional)
Program I participated in at Greene Inc.
    (check all that apply):		 Work Adjustment
Work Assessment
Placement
Job Coaching

Please answer the following questions by circling the response that best applies
5=All the time  4=Most of the time  3=Average  2=Seldom   1=Never  N/A=Not Applicable
My Job Coach/Placement Specialist was helpful -
5
4
3
2
1
N/A
My Placement Specialist provided me with good job leads -
5
4
3
2
1
N/A
My Job Coach/Placement Specialist listened to my concerns -
5
4
3
2
1
N/A
My Job Coach/Placement Specialist treated me with respect -
5
4
3
2
1
N/A
I was included in decisions regarding my plan -
5
4
3
2
1
N/A
I feel I benefited from my Job Coaching/Placement program -
5
4
3
2
1
N/A
The length of time my Job Coach was with me was reasonable - Yes No
The length of time it took for me to obtain a job was reasonable - Yes No
I am satisfied with the Job Coaching I received - Yes No
I am satisfied with my Placement Program - Yes No
I would recommend services from Greene Inc. to others - Yes No

Thank you for taking the time to complete this survey.
Please use this space for any additional comments.