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Client Resources

These forms are for current or past clients only.

SERVICE EVALUATION FORM

Thank you for taking the time to answer these questions. We want to know how helpful our services are to you, so your feedback is very important to us. Your answers will be kept confidential and nothing you say will affect the services that you receive. This survey does not ask for your name or contact information, this is completely anonymous feedback.

Client Survey

10 + 5 =

CLIENT NOTICE OF GRIEVANCE PROCEDURE FORM

Clients are entitled to file a grievance if they have a complaint about the services they received from Crisis Intervention Services (CIS). It is encouraged that clients address the concern directly with the staff member. If this is not possible or a satisfactory resolution has not been reached, a grievance form may be requested to proceed with the grievance process. Grievance forms are available from any staff member at CIS or by emailing help@stopdvsa.org or calling 641-673-0336. The forms can be mailed, emailed or picked up in person.

I Agree

10 + 14 =