Laserfiche WebLink
EXHIBIT C <br /> <br />SAMPLE CLIENT SATISFACTION SURVEY <br /> <br />1. Did you find this call to the Warmline helpful? <br />2. Do you believe the Warmline counselor understood your concerns, problems, or challenges? <br />3. Would you call the Warmline again if you needed assistance? <br />4. Would you refer a family member or friend to this Warmline? <br /> <br />SAMPLE DEMOGRAPHIC INFORMATION QUESTIONS <br />1. What is your city of residence? <br />2. What is your zip code? <br />3. What is your age? <br />4. What is your gender? <br />5. What is your ethnicity? <br />a. Hispanic <br />b. Not Hispanic <br />6. What is your Race? <br />a. White <br />b. Black/African American <br />c. Asian <br />d. American Indian or Alaskan Native <br />e. Native Hawaiian or Pacific Islander <br />f. Amer. Ind. or Alask. Native and White <br />g. Asian and White <br />h. Black/African American and White <br />i. Amer. Ind/Alask. Nat. and Blk/Afr. Amer. <br />j. Other Multi-Racial Combinations <br />7. What is your annual household income? <br />a. Extremely low-income (0-30% AMI) <br />b. Very Low Income (31-50% AMI) <br />c. Low Income (51-80% AMI) <br />d. Moderate Income (>80% AMI) <br />8. What is your household type? <br />a. Homeless <br />b. Female-Headed Households <br />c. Disabled/Special Needs <br />d. San Leandro residents <br /> <br />259