Evaluatio




									Information, Referral and Advocacy Evaluation This form is used to evaluate our services. Your feedback is extremely important. It will help us decide how to best meet the needs of those accessing our centre.

	1. Was the information and assistance you received helpful?

																							Somewhat helpful																	Not helpful

												Very helpful



		2. How would you describe the ACF staff member that you spoke with?

																										Somewhat satisfied
																																						Extremely satisfied
																Not satisfied


								Knowledgeable

																																	4

																			1																							5
																															3
																								2






							Pleasant
																		1
																													3
																								2																	5
																																			4






								Helpful
																		1
																														3						4
																									2																			5





					3. Did the centre have the resources you were looking for?

																						Somewhat satisfied											Extremely satisfied
													Not satisfied



															1													3				4					5
																				2


						4. What age group were you seeking information about?

											Autism										PDD NOS																		Asperger Syndrome



										Other:


							5. What age group were you seeking information about?


														1-5			6-10										11-13							14-18									19 and over


			6. After speaking to ACF, I felt?



				7. Additional comments:



Thank you for taking the time to let us know how we are doing! Your feedback is important to Autism Connections Fredericton