Youth Program Service Coordination Survey Form
Please complete this survey to help us improve the coordination of youth program services. Your feedback is valuable.
What is your relationship to the youth program?
*
Youth participant
Parent or guardian
Program staff
Community partner
Other
Please rate your satisfaction with the following aspects of our youth program service coordination.
*
Rows
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Communication between program staff and families
1
2
3
4
5
Timeliness of service delivery
6
7
8
9
10
Coordination among different service providers
11
12
13
14
15
Accessibility of services
16
17
18
19
20
How easy is it to access the services you need through the program?
*
Very easy
Somewhat easy
Neutral
Somewhat difficult
Very difficult
Which types of services have you or your family used through our program? (Select all that apply)
*
Academic support
Counseling/mental health
Career or job readiness
Health services
Recreation/enrichment
Other
Please rate the importance of the following services for youth in our program.
*
Rows
Not important
Slightly important
Moderately important
Very important
Essential
Academic support
21
22
23
24
25
Mental health services
26
27
28
29
30
Job readiness training
31
32
33
34
35
Health and wellness services
36
37
38
39
40
Recreation and enrichment
41
42
43
44
45
What barriers, if any, have you experienced in accessing program services?
*
Transportation
Scheduling conflicts
Lack of information
Limited program availability
No barriers
Other
How would you rate the overall coordination of youth program services?
*
1
2
3
4
5
What suggestions do you have for improving our service coordination?
If you would like to be contacted for follow-up, please provide your preferred contact method.
Email
Phone
No follow-up needed
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