Child Welfare Client Feedback Form
Name (optional)
Date
Your Relationship to the Child
Parent/Guardian
Foster Parent
Relative
Youth/Child
Other
1. How would you rate your overall experience with our child welfare services?
Excellent
Good
Average
Poor
Very Poor
2. Do you feel that your concerns were listened to and addressed?
Always
Usually
Sometimes
Rarely
Never
3. Was the information provided to you clear and helpful?
Always
Usually
Sometimes
Rarely
Never
4. What did you find most helpful about our services?
5. What changes would you suggest to improve our services?
6. Additional Comments