APS Client Questionnaire Web Version
Adult Protective Services Outcomes Study
APS_Client_Outcomes_Study_Client_Questionnaire_v4_83C Tracked
Adult Protective Services Outcomes Study
OMB: 0985-0065
OMB Control Number 0985-0065
Expiration Date: 1/31/2023
CLIENT QUESTIONNAIRE
Dear Client,
If you are completing the form yourself: The study team at New Editions Consulting would appreciate your feedback about your most recent interaction with [name of APS Program]. [Description of APS program and types of services to cue the respondent, to the greatest extent possible, into answering the questions based on their experience with APS, rather than other services they may be receiving]. Please take a few minutes to answer all of the questions on the next page by marking the rating that best matches your opinion. Please choose only one answer per question. Then, place the completed form in the pre-paid envelope and mail it to us. If you prefer to complete the form online instead of on paper, you can use the following link: www.surveymonkey.com/r/APSclient. By submitting the form, you are agreeing to, or giving your consent, for your answers to become a part of our study. Your feedback will help us improve our work and will be kept completely private. Thank you for sharing your feedback!
If you are completing the form on behalf of the APS client: The study team at New Editions Consulting would appreciate your feedback about the client’s most recent interaction with [name of APS Program]. [Description of APS program and types of services to cue the respondent, to the greatest extent possible, into answering the questions based on their experience with APS, rather than other services they may be receiving]. Please take a few minutes to answer all of the questions on the next page by marking the rating that you think best match the client’s opinion (put yourself in the client’s shoes). Please choose only one answer per question. Then, place the completed form in the pre-paid envelope and mail it to us. If you prefer to complete the form online instead of on paper, you can use the following link: . www.surveymonkey.com/r/APSclient HYPERLINK "http://www.surveymonkey.com/r/APSclient"
Stephanie.WhittierEliason@acl.hhs.gov
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | CLIENT QUESTIONNAIRE |
| Author | New Editions Consulting, Inc. |
| File Modified | 0000-00-00 |
| File Created | 2021-01-14 |
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