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Home Delivered Meals Program
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Home Delivered Meals Program
Home Delivered Meals Program
Scott Monheimer
2025-01-31T08:06:26-05:00
Home Delivered Meals Program
Client Satisfaction Survey
Aging Survey Home Delivered Meals
Receiving the meals has improved my capacity for independent living and/or increased my social support
Agree
Disagree
Has joining the HDM Program helped you remain independent?
Yes
No
Has joining the HDM Program helped you to eat regular scheduled meals?
Yes
No
Has joining the HDM program provided you some socialization (by the volunteer)?
Yes
No
Overall, I am satisfied with the volunteer that delivers the meals
Yes
No
Do you have any grievances or complaints regarding the Senior Nutrition Program that you would like to state?
Are you aware that you can receive one-on-one counseling with a Registered Dietitian?
Yes
No
Have you received any nutrition education from the Saratoga County Dietitian in the past 12months?
Yes
No
If so, did you find the education session useful?
Yes
No
Do you have any nutritional questions you would like answered by the Dietitian?
Yes
No
If yes, please give your name and number below
How long have you been receiving the home delivered meals?
What is your favorite meal?
What is your least favorite meal?
Is there a specific menu item you would like us to add in the future?
Is the person who brings the meals friendly/courteous?
Yes
No
Some changes have been made to the meal program and new food items have been added. Please let us know how you feel about these changes
If you have any additional comments regarding the HDM Program please list them below
Optional: Name:
Optional: Phone Number:
Submit Form
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