Satisfaction Survey - Saratoga Bridges

Please answer all of the questions and include additional comments you would like to address in the spaces provided. The information you provide will be used to evaluate the quality of our services your loved one receives. All responses will be kept confidential!

Name of Individual Served (optional)

Please choose from the following list (Check all that apply):

Residential/Family Care
Day Habilitation/OPTS
Medicaid Service Coordination
Transportation
Pallet Shop/Pre-Voc
Supported Employment
Family Support Services

Please choose from the list provided in answering the questions below.

(1) How satisfied are you with the Services provided by Saratoga Bridges?

Comments:

(2) How satisfied are you with the responsiveness of the program staff to any issues/concerns you have raised?

Comments:

(3) How satisfied are you with the management of this program?

Comments:

(4) How satisfied are you with how the needs of your loved one are being met?

Comments:

(5) Please let us know if there are any Saratoga Bridges employees who you would like to recognize for their good/outstanding performance (s) in working with your family member.

Names:

(6) How satisfied are you with the overall quality of this program?

Comments:

Please give your answers to the following questions in the space provided.

Program 1: Please select from the drop-down options the program you are reviewing.

What do you like most about this program?

Are there any aspects of the program that need improvement?

Do you have any suggestions on ways to better communicate with families?

Do you know whom to contact if you have a problem with this program?

Would you recommend this program/service to others?

Would you like to review another program?

Program 2: Please select from the drop-down options the program you are reviewing.

What do you like most about this program?

Are there any aspects of the program that need improvement?

Do you have any suggestions on ways to better communicate with families?

Do you know whom to contact if you have a problem with this program?

Would you recommend this program/service to others?

Would you like to review another program?

Program 3: Please select from the drop-down options the program you are reviewing.

What do you like most about this program?

Are there any aspects of the program that need improvement?

Do you have any suggestions on ways to better communicate with families?

Do you know whom to contact if you have a problem with this program?

Would you recommend this program/service to others?

We would appreciate receiving your most current address, phone number(s), and e-mail address.

Name

First Last

Day Phone#

Night Phone#

E-mail Address

Address

Street Address Address Line 2 City State ZIP Code

Please share any additional comments you may have below:

Thank you for your feedback!

We value your comments and will address any concerns you have made while using ideas you have presented in our future programmatic designs.

Jane Mastaitis, Executive Director,jmastaitis@saratogabridges.org, or call 518-587-0723, ext. 1251.
Stephen Ramos, Director of Quality Assurance & Corporate Compliance,sramos@saratogabridges.org, or call 518-587-0723, ext. 1229.