Your Full Name:

Your E-mail Address: (required)

The Program Name:

Age of the Person you Enrolled or Wanted to Enroll:

Your Relationship to the Person: Father Mother Parent Professional Relative Other select

If you enrolled this child, what was the Date Entered the Program:

If Enrolled, How Many Days Were they in the Program:

1.   How complete was the admission counselor's description of the:

2.  Yes    No   Did you feel the admission counselor misled you regarding the program?

Please explain. 

3.  Yes    No   Did you feel the written materials or web about the program were misleading?

Please explain.

Please complete the following if you enrolled a child or person

4.  How well were you informed about the status and progress of your child?

Extremely well,  Very well,  Acceptable,  Very poor,  Extremely poor

Please explain.

5.  How appropriate were the staff with your child?

Extremely appropriate,  Very appropriate,  Appropriate,  Very inappropriate,  Extremely inappropriate

Please explain.

6.  How competent did you feel the school staff were in this program?

Extremely competent,  Very competent,  Competent,  Very incompetent,  Extremely incompetent

Please explain.

7.  How competent did you feel the counseling/therapy staff were in this program?

Extremely competent,  Very competent,  Competent,  Very incompetent,  Extremely incompetent

Please explain.

8.    Yes    No   Did the program refer you to a transport service?

Please tell us who and what happened.

9.     Yes    No    Do you feel the program was manipulated by your child or turned against you?

 Please explain.

10.  How well did the program listen and understand you concerns?

Extremely appropriate,  Very appropriate,  Appropriate,  Very inappropriate,  Extremely inappropriate

Please explain.

11.    Yes    No   Did you complain about the staff or the program at any time?

Please explain.

12.  How ethical was the program?

Extremely ethical,  Very ethical,  Ethical,  Very unethical,  Extremely unethical

Please explain.

13.    Yes    No   Were there any circumstances that gave you cause to worry for your child's safety?

Please explain.

14.      Yes    No   Did you encounter any unprofessional behavior on the part of the program?

Please explain.

15.  How satisfied were you with the program's overall performance?

Extremely satisfied,  Very satisfied,  Satisfied,  Very unsatisfied,  Extremely unsatisfied

Please explain.

Your individual responses to this questionnaire will be kept private. This web site is not affiliated with any programs. Transmission by e-mail is more secure that standard postal mail.