CHILDREN’S ADVOCACY CENTER of BENTON COUNTY SURVEY

Dear Parent/Guardian,

The following is a survey evaluating our abilities to aid you and your family throughout your time here at the Children’s Advocacy Center (CAC).  Please rate the following services your child received while at the CAC.  When you have completed the survey, please return it in the postage-paid envelope provided.  Thank you for your response.

 1.  Did you receive helpful information from a CAC staff member?   ______ Yes   _____No 

    2.      Do you feel that the home-like environment made your experience with the CAC more

          comfortable and less stressful?   ________  Yes   _________  No

     3.  Did you feel comfortable with the CAC staff member?   ________  Yes   ________  No

     4.  Were you well informed as to the purpose of the CAC and its non-investigative role in the  

     investigation process?   ________  Yes   ________  No

5.      Please circle the response that best describes your evaluation of the CAC:

Information provided was                              Excellent               Good               Fair                Poor

Needs of the parent/guardian(s) were met      Excellent               Good               Fair                Poor

Emotional support was                                   Excellent               Good               Fair                Poor

Needs of the child were met                           Excellent               Good               Fair                Poor

6.      If your child received a medical exam, please circle the response that best describes your evaluation

      of the service provided:

      How well did the staff prepare your child for the exam?                 Excellent     Good      Fair      Poor

      Was the exam room a “friendly” place for your child?                     Excellent     Good      Fair      Poor    

      How well did the nurses listen/address you and your concerns?      Excellent     Good      Fair      Poor

      Did you receive clear information regarding the exam?                   Excellent     Good      Fair      Poor

      Overall, how would you rate the medical service?                           Excellent     Good      Fair      Poor

7.      Suggestions or additional comments regarding the Children’s Advocacy Center and staff:

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