Consumer Satisfaction Survey

 

We value your opinions and input. If you’ve recently received services from us, please consider filling out our customer satisfaction survey below to help us better serve you.

 

Question one (1) seeks to discover what direct service you sought and/or received. Please check all that apply.
 Benefits Advisement
 Peer Counseling
 Information and Referral
 Advocacy
 Housing Assistance
 Support Group
 Education Presentation
 Architectural Barrier Consulting
 Independent Living Skills Training
 Employment Training
 Letter of Support
 Other

If you checked "other", what other services did you receive?

Questions two (2) through six (6) relate to the quality of your contact with us. Your opinion here will assist us in improving MILC Inc.'s service delivery. Please use the boxes below to enter a number between 1 and 9 for each question to gauge your satisfaction, with 1 being the worst (poor) and 9 being the best (very good).

Courtesy and respect shown to me by the staff was:
Staff knowledge of the issue(s) concerning me was:
The help given me in my dealing with the issue(s) was:
Access to Staff and/or the prompt return of my calls was:
The level of control I had in reaching my goal(s) was:

Given the immense size of the area we serve, your help is needed to assist us in pinpointing localized disability concerns. Please tell us about the current state of Handicapped Accessibility in your area. Question seven (7) asks for the Township and Village you are most familiar with. Question eight (8) seeks to identify places of public accommodation that are not handicapped accessible, and asks for a brief description of what you think they lack.

I have disability concerns in the town or village of:

I know that the following local businesses (give name and address below) lack some level of Handicap Accessibility:
A:
Specific problem:
B:
Specific problem:
C:
Specific problem:
D:
Specific problem:

For people with disabilities, the struggle for equality, respect and freedom to lead an independent lifestyle has only recently become something resembling an organized fight. The MILC, Inc. works with the leaders of the Disability Rights Movement in this Country to keep the momentum going. There are approximately 15,000 individuals with disabilities living in our St. Lawrence and Franklin Counties. We are seeking those interested in joining in these efforts. Please strongly consider nominating someone with a disability (yourself or someone else) who you feel we can call upon to assist. Additionally, MILC is seeking fellow individuals with disabilities in our community who are willing to act in an advisory capacity in MILC's effort to address issues of disability concern.

Name of Nominee:
Telephone:
Address:

Name of Nominee:
Telephone:
Address:

Please type the code shown in the box below.
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St. Lawrence County Phone:

(315) 764 - 9442

 

Franklin County Phone:

(518) 483 - 2151

 

Toll Free Phone:

(877) 397 - 9613