AIHS Web Site Survey

Was our Web site easy to use?

1 - Very easy 2 - Somewhat easy 3 - Somewhat difficult 4 - Very difficult

How organized did you find our Web site?

1 - Very organized 2 - Somewhat organized 3 - Mediocre 4 - Completely unorganized

How helpful was the Web site information?

1 - Very Helpful 2 - Somewhat helpful 3 Neither helpful nor unhelpful 4 - Unhelpful

How did you hear about the Web site?

Please indicate if you reside in one of our 9 northeasten counties:

Adams Allen DeKalb Huntington LaGrange Noble Steuben Wells Whitley Other

Other - Please list county and state:

Would you like to receive additional information about Aging and In-Home Services of Northeastern Indiana, Inc. and its services?

Yes No

If so, provide your name and address and the type of information you’re looking for.

Name:

Street:

City: State: Zip:

Information Requested:

Thank you for taking the time to fill out our survey!

* Don’t forget: You can make a donation to AIHS by printing off the donation form on our donate page!!