Program Service Evaluation

Office of AccessabilityProgram Service Evaluation

Please take a moment and complete this evaluation form. Your feedback will assist us to continually improve our services. Please print and return the completed evaluation to room E1214/N300. We request that you fill out this form once a semester.

Thank you,

Current Semester and Year *
Are you registered with the Office of AccessABILITY? *

Are you registered with the Office of AccessABILITY? Yes No
Number of times you have visited the office, during the current semester: *

Number of times you have visited the office, during the current semester: Once Twice Three times Four times Five times Six times or more
Please check any services that you have so far been able to utilized within our program: *

Please check any services that you have so far been able to utilized within our program: Academic Advising/Counseling (appeals, course withdrawl, add/drop, etc.) Advocacy Deaf and Hard of Hearing Advising/Advocacy Interpreting/CART/Oral Interpretation Note Taking Services Reader Services Locker Request Tutoring Referrals (Reading/Writing/Math Centers, etc.) Foreign Language Course Substitution Outside Referral (LD Evaluation, Psychiatric, etc.) Placement Exam Accommodations Study Abroad Program Accommodations Testing Accommodations Alternative Text Format Assistive Technologies Early Registration LEADS Counseling/Career Services Financial Aid (e.g. Part Time TAP) Workshops and Events Other
Please use the following scale to indicate your agreement with the statements below:

1 = Strongly Disagree
2 = Somewhat Disagree
3 = Somewhat Agree
4 = Strongly Agree
*

Please use the following scale to indicate your agreement with the statements below:

1 = Strongly Disagree
2 = Somewhat Disagree
3 = Somewhat Agree
4 = Strongly Agree
Counseling Services
I was satisfied with my reception in room 1214B East Building.

I was satisfied with my reception in room 1214B East Building. 1 2 3 4 N/A
The staff was able to assist me with my academic/disability concerns. *

The staff was able to assist me with my academic/disability concerns. 1 2 3 4 N/A
The staff was able to direct me to the proper counselor/Advisor who was able to assist me with my academic/disability needs. *

The staff was able to direct me to the proper counselor/Advisor who was able to assist me with my academic/disability needs. 1 2 3 4 N/A
The counselor made me feel at ease so that I could express and discuss my concern(s). *

The counselor made me feel at ease so that I could express and discuss my concern(s). 1 2 3 4 N/A
The counselor was well informed about disability and/or academic related processes. *

The counselor was well informed about disability and/or academic related processes. 1 2 3 4 N/A
I left the counselor with a better understanding of my problem(s), options and way to work towards resolving them. *

I left the counselor with a better understanding of my problem(s), options and way to work towards resolving them. 1 2 3 4 N/A
The counselor followed up with my request(s) and helped me to resolve my concerns. *

The counselor followed up with my request(s) and helped me to resolve my concerns. 1 2 3 4 N/A
The counselor helped me to recognize my potentials and learn to become more independent. *

The counselor helped me to recognize my potentials and learn to become more independent. 1 2 3 4 N/A
Access & Technology Center (Testing)
I was satisfied with my recetion in the Access and Technology Center (N300). *

I was satisfied with my recetion in the Access and Technology Center (N300). 1 2 3 4 N/A
The Access Center's staff were able to assist me with my academic/disability concerns. *

The Access Center's staff were able to assist me with my academic/disability concerns. 1 2 3 4 N/A
The center staff was able to direct me to the proper counselor who was able to assist me. *

The center staff was able to direct me to the proper counselor who was able to assist me. 1 2 3 4 N/A
The assistive technology personnel made me feel at ease so that I could express and discuss my need(s). *

The assistive technology personnel made me feel at ease so that I could express and discuss my need(s). 1 2 3 4 N/A
The staff was well informed about disability and assistive technology software/hardware and their applications. *

The staff was well informed about disability and assistive technology software/hardware and their applications. 1 2 3 4 N/A
The testing staff were able to assist me with accommodations for exams (CUNY placement, midterms/finals) upon my request in a timely fashion. *

The testing staff were able to assist me with accommodations for exams (CUNY placement, midterms/finals) upon my request in a timely fashion. 1 2 3 4 N/A
The Testing staff made sure that I received timely accommodations, once I met all the requirements and followed the guidelines of the program. *

The Testing staff made sure that I received timely accommodations, once I met all the requirements and followed the guidelines of the program. 1 2 3 4 N/A
I was able to get my text in alternate format in a timely manner and when that was not possible, the center provided me with alternatives. *

I was able to get my text in alternate format in a timely manner and when that was not possible, the center provided me with alternatives. 1 2 3 4 N/A
Please print and drop this form off at Room 1214B East Building

Thank You
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Program Service Evaluation

Office of AccessabilityProgram Service Evaluation

Counseling Services

Access & Technology Center (Testing)

Please print and drop this form off at Room 1214B East Building Thank You

Please print and drop this form off at Room 1214B East Building

Thank You