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<br />EXHIBIT C <br /> <br /> <br />CLIENT SATISFACTION SURVEY <br /> <br />The following Survey is completed at the time client exits the program. <br />Staff will ask the resident to complete this voluntary Survey. <br /> <br /> <br />Client Exit/Satisfaction Survey <br /> <br />We are asking you to complete this brief survey to help us evaluate our program. <br />Please feel comfortable to answer freely. Responses will be kept anonymous. <br />Thank you for your time. <br /> <br />Date: _____________________ Length of stay: _____________________ <br /> <br />Name: <br />______________________________________________________________________________ <br /> <br />Children’s Names: <br />______________________________________________________________________________ <br /> <br />I am going to (Please Check): <br /> <br />_____ Permanent housing/own <br />apartment <br />_____ Shared housing <br />_____ Residential program <br />_____ Drug/alcohol program <br />_____ Transitional housing program <br />_____ Friends/Relatives <br />_____ Specialized Shelter <br />_____ Hotel/Motel <br />_____ Streets <br />_____ Unknown <br />_____ Other: <br />_____________________________ <br />153