Client Exit Survey

1. Biographical Information

Date:
Name: (optional)
Length of Supervision: (months)

2. Who was your supervision officer?

3. Please rate your interactions with your ISO:

"I was highly motivated when assigned to probation."
 Strongly Agree Agree Disagree Strongly Disagree
"During my intake appointment with my ISO, program requirements and expectations were explained to me."
 Strongly Agree Agree Disagree Strongly Disagree
"During my supervision period, my ISO answered any questions I had in a timely manner."
 Strongly Agree Agree Disagree Strongly Disagree
"During my supervision period, my ISO explained my probation requirements to me so I could understand them."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO was on time for scheduled appointments."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO treated me with respect."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO treated me fairly and consistently."
 Strongly Agree Agree Disagree Strongly Disagree
"I always thought my ISO was there to help me."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO encouraged my participation in the development and review of my supervision plan."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO conducted home visits in a professional and respectful manner.
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO was flexible in regards to scheduling appointments in conjunction with my work and/or treatment schedule."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO allowed my family members to participate in my supervision when requested."
 Strongly Agree Agree Disagree Strongly Disagree
"My ISO worked with me in regards to making payments to the Disctrict Court and/or Community Corrections."
 Strongly Agree Agree Disagree Strongly Disagree
"My opinion of Community Corrections has improved."
 Strongly Agree Agree Disagree Strongly Disagree
"I would rate my overall supervision experience as 'good.'"
 Strongly Agree Agree Disagree Strongly Disagree

4. Please answer the following sections pertaining to services you may have received: Part 1- Drug Testing Services

"The drug testing procedures were explained to me."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"Drug testing helped me refrain from using drugs."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"I used illegal drugs while on supervision, but was not caught."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"I used a masking agent to mask my illegal drug use."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"I was caught using and was referred for evaluations and/or treatment."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"My ISO assisted me in accessing treatment services."
 Strongly Agree Agree Disagree Strongly Disagree N/A

5. Part 2 - Alcohol and Drug Treatment Services

"My treatment was located close to home."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider met with me as scheduled."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider was flexible in scheduling appointments."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider treated me with respect."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider was there to help me."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"My alcohol and drug treatment was beneficial."
 Strongly Agree Agree Disagree Strongly Disagree N/A
Name of provider:

6. Part 3 - Mental Health Treatment Services

"My treatment was located close to home."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider met with me as scheduled."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider was flexible in scheduling appointments."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider treated me with respect."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The provider was there to help me."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"My alcohol and drug treatment was beneficial to my success."
 Strongly Agree Agree Disagree Strongly Disagree N/A
Name of provider:

7. Part 4 - Cogntive Education Classes

"The facilitators were knowledgeable of the curriculum."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The facilitators were prepared for class sessions."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The facilitators treated me with respect."
& Strongly Agree Agree Disagree Strongly Disagree N/A
"The facilitators were there to help me."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The cognitive education classes were helpful."
 Strongly Agree Agree Disagree Strongly Disagree N/A

8. Part 5 - Workforce Development Program Services

"The facilitators were knowledgeable of the curriculum."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The facilitators were prepared for class sessions."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The facilitators treated me with respect."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The facilitators were there to help me."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The cognitive education classes were helpful."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The Workforce Development Student Handbook provided by Community Corrections was helpful."
 Strongly Agree Agree Disagree Strongly Disagree N/A

9. Part 6 - Community Service Work

"I had several options for completing my community service hours."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"The community providers treated me with respect."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"I enjoyed my community service work."
 Strongly Agree Agree Disagree Strongly Disagree N/A
Name of service agency:

10. To better the services we provide, we would appreviate your input on the following:

"Increased home visits are a good idea."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"Increased employment visits are a good idea."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"Employment workshops would help me find a job."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"Budget workshops would help me budget my money better."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"Employment contact by my ISO helped my job situation."
 Strongly Agree Agree Disagree Strongly Disagree N/A
"Clients should only be billed for positive drug screens."
 Strongly Agree Agree Disagree Strongly Disagree N/A

11. Which of the following times would have worked best for office visits?

 7 am - 5 pm 8 am - 5 pm 8 am - 7 pm 8 am - 9 pm
If other, please specify:

12. Which days of the week would have worked best for office visits? Please mark all that apply)

 Monday Tuesday Wednesday Thursday Friday Saturday Sunday

13. If you marked Saturday or Sunday, please mark the times that would have worked best for office visits on these days.

 10 am - 1 pm 8 am - 11 am 12 pm - 3 pm 8 am - 5 pm N/A

14. How were you released from probation? (I.E. successful, unsuccessful, revoked)

15. What benefited you most during your supervision with Community Corrections?

16. If there were things Community Corrections could have changed to better serve you, what would they be?

17. Were you honest when answering this survey?

 Yes No Somewhat I told you what you wanted to hear

18. Additional Comments Regarding Client Interactions:

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