Thank you again for your time and feedback!
Food Services Client Satisfaction Survey
[Organization] strives to treat all clients with dignity, respect and fairness. We also strive to provide valuable and
quality services to all members of our community. You can help us by letting us know how well we are doing to
achieve these goals. If possible, please take a few moments to complete the survey questions below. Your
responses will remain completely anonymous. Tell us what we need to work on—your responses will be
used to improve the quality of our services. Please answer as honestly as possible. Client satisfaction is
very important to us and we greatly appreciate your feedback in this area.
1. How many days a week do you eat at the [location]? _____ (1-5)
2. Please indicate your age group: ___ 18-25 ___ 26-35 ___ 36-45 ___ 46-60 ___ 60 and over
3. Do have children that eat at the [location]? ___ yes ___ no
if yes, what age group are they in? ___ 0-5 ___ 6-10 ___ 11-17
For questions 4 - 10, please use the following scale and
mark the appropriate box with your chosen rating. Excellent Good Fair Poor Comments?
4. Please rate the convenience of our hours of service.
______________
5. Please rate the courtesy and friendliness of the manager.
______________
6. Please rate the courtesy and friendliness of the
______________
volunteers.
7. Please rate the overall atmosphere and feel
______________
of the [location].
8. Please rate the quality of the food.
______________
9. Please rate the quantity of food.
______________
10. Please rate the variety of the food.
______________
11. Overall, how satisfied are you with your experience Very Mostly Somewhat Not at all
at [location] today?
[Organization] is considering moving its Life Skills Program to the [location]. The Life Skills Program is a weekly
educational class that focuses on topics such as budgeting, home ownership, and employment. Dinner and
childcare would still be provided.
12. Would you be interested in attending some of these Very Mostly Somewhat Not at all
classes?
If so, on which evenings could you attend? ____________________________________________
What topics would you like to see covered? ____________________________________________
Please use the space below to add other comments about the areas indicated above, or about any other
matters you would like to give us feedback about. Please indicate other services or information you would like to
see available at [location]. (Use back side also if more space is needed):
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