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Menu
Referrals
Alliance Referral System
Send A Referral
Membership
Join The Alliance
Member Directory
Login
Membership FAQ’s
Accreditation
About Accreditation
Enhancing Credibility
Events
Event Calendar
Sheltered Conference
About Us
Who We Are
Public Reports & Press
Contact
Jobs
Work With Us
Job Board
Post A Job
Employer Dashboard
Get Involved
Join The Arbor
Request A Speaker
Church Partnership
Shop The Store
Donate
Give Monthly
One-Time Gift
Partnership Referral from a Former Client Organization
Partnership Review From Former Client/Participant
This form is a way for NTSA to evaluate the program you participated in, in order to ensure it is a good fit for other prospective participants. You may remain anonymous or choose not to fill out this form if you do not feel comfortable sharing your experiences. If you have any questions please reach out to membership@shelteredalliance.org.
Name
First
Last
This is not required, you may remain completely anonymous.
What organization do you represent?
This is not required, you may remain completely anonymous.
Can we follow up with you after this survey if necessary?
Yes
No
If yes, please write in the best way to contact for any follow-up questions:
Program/Service you participated in:
What month/year did you complete the service?
Open-Ended Questions
Did this provider's orientation to services adequately explain the experience?
If you could change one thing about the program or give leadership one suggestion for improvement, what would it be?
Please Score 1-5
On a scale with 1 being strongly disagree and 5 being strongly agree.
I am satisfied with the services I received from this provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
I would come back to this provider if I needed help again.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
I would recommend this provider to other organizations in my network.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
This provider offered referrals to other organizations or services.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
My organization has improved programmatically because of the provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
My organization has improved operationally because of the provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
My organization has improved financially because of the provider.
1 - strongly disagree
2 - disagree
3 - neutral
4 - agree
5 - strongly agree
[my_acf_user_form field_group="12979"]
