Satisfaction Survey

How old was the youth at the time of their JIAC assessment? *

Had the youth been assessed at JIAC previously? *

Yes

No

The Intake Specialist who worked with my family was: *

Were you and/or your child connected to appropriate services? *

Definitely

For the most part

Not really

Definitely Not

If no, what services did you and/or your child need that you did not receive?

Have you/do you plan to use the services referred? *

Yes

No

What did you find most helpful about the JIAC intake process?

What changes would you suggest to improve the JIAC intake process?

Additional Comments:

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