Please complete the following evaluation to assist us in improving services. All responses are anonymous. Your feedback is important to us!

1

Referral to the Program:

Referral to the Program:

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Prosecutors explained the program in a way that I could understand during my hearing.	Referral to the Program:	Referral to the Program:	Referral to the Program:	Referral to the Program:	Referral to the Program:
I understood the benefit of accepting a diversion/probation program prior to my intake.	Referral to the Program:	Referral to the Program:	Referral to the Program:	Referral to the Program:	Referral to the Program:
I am satisfied with the outcome of my case.	Referral to the Program:	Referral to the Program:	Referral to the Program:	Referral to the Program:	Referral to the Program:

2

Interaction with Human Services:

Interaction with Human Services:

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
My counselor was courteous and respectful.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
My counselor was knowledgeable.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
My counselor responded to my needs.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
My counselor clearly explained program guidelines and requirements.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
Service from my counselor was provided in a timely manner.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
My counselor was able to answer questions related to my case.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
I was able to reach my counselor when needed.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:
I am satisfied with my overall experience with the Community Supervision Program.	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:	Interaction with Human Services:

3

Since finishing the program...

Since finishing the program...

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I have a better understanding of the criminal justice system.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have a better understanding of how my thinking affects my behavior.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have decreased drinking/drug use.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have better self-esteem.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have better communication skills.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have better coping skills.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have a better understanding of social services available in my community and how to access them.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...
I have an understanding of how my actions affected people around me and the community that I live in.	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...	Since finishing the program...

4

I feel that...

I feel that...

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
This incident significantly affected my life.	I feel that...	I feel that...	I feel that...	I feel that...	I feel that...
I have been given a second chance.	I feel that...	I feel that...	I feel that...	I feel that...	I feel that...
I have benefitted from the program requirements.	I feel that...	I feel that...	I feel that...	I feel that...	I feel that...
This program was the best choice for me.	I feel that...	I feel that...	I feel that...	I feel that...	I feel that...

5

Additional Comments:

Additional Comments:

6

Assigned Program:

Assigned Program:(Select an Answer) Adult Diversion Program (ADP) Title IX Diversion Supervised Probation

7

Charge/Offense:

Charge/Offense:

8

Counselor:

Counselor:(Select an Answer) Amanda Chavez Debbe Webster Janet Blake Janet Kasha Michael Abramson Natalie Jimenez Sabrina Nelsen Unsure

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