EmailMe Form - Satisfaction Survey

Consumer's Name *

Behavior Consultant *

Behavior Consultant Supervisor *

1. The Behavior Consultant (BC) arrives on time for scheduled appointments *

2. The BC is respectful and interacts appropriately wtih consumers *

3. The BC accepts and encourages input from all team members *

4. The BC attends scheduled team meetings *

5. The BC notifies team members when needing to cancel visits/appointments in a timely manner *

6. Behavior Support Plans and other reports are understandable *

7. The BC provides data (and analysis of data) to team members on a regular basis *

8. The consumer is benefitting from services provided *

9. The BC maintains a professional appearance in dress and actions *

10. The team has regular contact with the Behavior Consultant Supervisor (BCS) at team meetings and other times as needed *

11. The BCS is an important member of the team *

12. The BCS assures that services are provided in the manner expected *

13. The Cornerstone Agency as a whole provides quality services to individuals with disabilities *

14. I would recommend The Cornerstone Agency to others *

Comments:

Person Completing Survey *

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