Please select the title which most closely describes your role:   

1. Please provide your opinion on the following statements regarding Newhope's accomplishment of its Vision and Mission:
Strongly
Agree		 Moderately
Agree		 Moderately
Disagree		 Strongly
Disagree
Individuals are supported to live meaningful lives. 
Individuals have friends, family or other people who provide them with support and assistance. 
Individuals are supported to increase their community participation and inclusion. 
Individuals are provided with the information and resources to empower them to make decisions and control their lives. 
Individuals are made aware of all the services and supports available through Newhope and in the community. 
Individuals understand and participate in person-directed planning. 
Individuals understand what Self-Determination is all about. 
Individuals' expressed concerns are heard and considered. 
Individuals supported by Newhope are treated with dignity and respect. 
Individuals have the necessary services and supports available to promote their basic health and safety. 

2. Please provide your satisfaction rating in each of the following areas that apply to you:
Very Satisfied Satisfied Not Satisfied N/A
Appleseed Childcare 
Early Childhood Center 
Family Resources 
IO/SL/Level 1 Waiver Services 
Psychological Services 
Recreation 
Residential (Raintree, Watts, Cherry Hill, Glendale, Woodville) 
RNI Community Employment Services 
RNI Workshops (4th Street, Longview, Work Crews) 
Service Coordination 
Therapy (OT, PT, Speech) 
Transportation 

3. Please list any areas in the services and supports that are currently provided that need improvement:

4. Please list recommendations for change in areas you listed in the previous question:

5. Please list other services and supports that you need or want that are not currently provided:

6. Please list areas, services and supports, etc. that you feel are exceptional or are strengths of Newhope:

Comments:

Thank you for interest and input.  If you would like a personal reply about any issue you identified above, please enter your name and a daytime phone number or e-mail address in the spaces provided.

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