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275 Community Partner Application Confirmation
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Maryland Access Point (MAP) Satisfaction Survey

  1. Recently you received services from your local Frederick County (MAP). Please read and answer the following questions. Your feedback will help us improve our services. Thank you!
  2. 1. Age Range
  3. 2. Please check any of the following that apply to you:
  4. 3. Overall, how satisfied are you with the services provided?
  5. 4. How did you hear about the Frederick County Maryland Access Point?
  6. 5. If you were considering a nursing home, did the staff help you identify alternative options?
  7. 6. Please rate your agreement with the following:
  8. Overall the staff made me feel welcome.
  9. I would refer a friend or family member to Frederick County MAP.
  10. The staff listened to me and gave Individualized attention.
  11. The staff explained my options, including why some may not be available to me.
  12. I am better able to make decisions about my options after talking with the staff.
  13. The staff and I worked together to develop a plan for what to do next.
  14. Staff offered to explore additional needs beyond my reason for contacting them.
  15. Thank you for your feedback! We appreciate your time and thoughts. Please contact 301.600.1234
  16. Leave This Blank:

  17. This field is not part of the form submission.