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<br />CDBG Subrecipient Agreement between City of San Leandro and July 1, 2020 <br />Asian Health Services for Mental Health Warmline Services – Exhibit C Page 1 of 1 <br /> <br /> <br /> <br />EXHIBIT C <br /> <br />SAMPLE CLIENT SATISFACTION SURVEY <br /> <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 <br />challenges? <br />3. If the Warmline counselor informed or referred you to other services, did you find these <br />services helpful? <br />4. Would you call the Warmline again if you needed assistance? <br />5. Would you refer a family member or friend to this Warmline? <br />6. What is your city of residence? <br />7. What is your age? <br />0 - 15 years old <br />15 - 30 years old <br />30 - 45 years old <br />46 – 60 years old <br />60+ years old <br />Prefer not to answer <br /> <br />8. What is your ethnicity? (Using HUD guidelines) <br />9. What is your annual household income?" (Using HUD guidelines) <br /> <br />132