Evals: Client Feedback with Outcomes 2015 Header Image

Client Feedback Form


Hello and thank you for taking the time to let us know how we did by answering the below seven questions.


After you have finished those questions, you can click on "Submit" to send us your feedback. Or, if you have more time, you can choose to answer a few more questions.


Thank you!



Hola, gracias por tomarse el tiempo para permitirnos saber cómo lo hicimos.

Gracias por su tiempo.


1. On a scale of 1-10 (with 1 being low and 10 being high), how likely is it that you'd recommend VLN to a friend?*
3. How did you meet with the attorney?*
3A. Where was the legal clinic located?
4. Did we treat you well?*
5. Did we help with your problem?*
6. How did we help with your problem?
7. What type of legal issue did the VLN lawyer help you with?*
¿Con qué tipo de asunto legal VLN le ayudó?
¿Cuál es su nombre?
¿Cuál es su fecha de nacimiento?
Thank you for answering those questions. Would you like to answer some more?
¿Cuál fue el nombre del abogado (a)?
Did the lawyer recover any money for you?
¿Recuperó el abogado(a) algún dinero para usted?
¿Cuánto dinero recuperó el abogado(a) para usted?
Did the lawyer prevent any money from being taken from you?
¿Cuánto dinero protegió el abogado(a) para usted?
Would you be interested in joining a community advisory panel? The panel would meet 6 times a year, every other month in the evening starting in January, and would have influence on the policies and procedures of our program. One member of the panel would also attend meetings of our board of directors and report the ideas of the advisory panel.
What times of day would be best for you to have the meetings?
Thank you for answering those questions. Would you like to answer some more?

Thanks! Answer as many of the below questions as you want. Whenever you want to stop, just press "submit" at the bottom of the form so we get your feedback.

Did the services you received from your attorney keep your problem from getting worse?
¿Los servicios que recibió del abogado empeoraron su problema?
Did the attorney's services make a difference in your life?
¿Los servicios del abogado hicieron una diferencia en su vida?
How satisfied are you with your attorney's work?
¿Qué tan satisfecho está con los servicios del abogado?
Did the attorney treat you well?
¿Qué tan satisfecho está con los servicios del abogado?
Aunque usted estuviera muy satisfecho, por favor déjenos saber algo que VLN o su abogado hubiera podido hacer mejor
Detalles (si existen)
Would you recommend VLN to a friend?
¿Recomendaría VLN a un amigo?
We are currently gathering photos of clients to display in our conference room. Would you be interested in submitting a photo of yourself for consideration?
Would you be willing to give us your written permission to display your photo?
What address can we use to send you the waiver?
Please upload your photo here. We will contact you if we would like to display it.
No File Chosen
File uploads may not work on some mobile devices.
May we write up a story about how our services helped you?
May use your name?
If we have questions, may we email you?

Please check off any other places that helped you with this problem (such as helping you follow the attorney's advice).
What is your first language?
¿ Cúal es su primer idioma?
In what language was the legal service provided?
¿En cúal idioma el servicio legal fue provisto?
Would you like these answers to be shared with your attorney? (If yes, please be sure to enter your name or birthdate in the survey.)
¿Le gustaría compartir estas respuestas con el abogado?
We have client photos in our office (and sometimes publish them in magazines). Would you like to give us one of yourself?
Would you be willing to give us your written permission to display your photo?
Would you like us to email or mail it to you?
What address can we use to send you the waiver?
Please upload your photo here. We will contact you if we would like to display it.
No File Chosen
File uploads may not work on some mobile devices.
If you are still interested in answering more questions, click yes below. Otherwise, please press submit at the bottom of the page.

Last set of questions! (Feel free to stop at any time by hitting the "submit" button below.)

Did the lawyer's help make a difference in your life?

Your answers will help us know of our services are most helpful.

For any question, if your life improved, but NOT because of the lawyer's help, please answer "no."

¿La ayuda del abogado (a) hizo una diferencia en su vida?

Tal vez lo hizo o tal vez no, sus respuestas a continuación nos ayudarán a saber cuales de nuestros servicios son más útiles.

Por cada pregunta, si su vida mejoró pero NO por la ayuda del abogado (a), por favor responda "no"

Did the lawyer's help make it easier to pay for daily necessities
Did the lawyer's help give you relief from creditor harassment?
Did the lawyer's help make it easier to find or keep a job?
Did the lawyer's help make it easier to find or keep housing?
Did the lawyer's help make it easier to find better housing?
Did the lawyer's help make it easier to stay safe?
Do you have minor children living with you?
Did the lawyer's help protect your relationship with these children?
Did the lawyer's help protect any important relationships besides children?
Did the lawyer's help make it easier to keep children safe?
Did the lawyer's help result in better quality of life for you?
¿Cuántos niños menores tiene?
Did the lawyer's help improve your quality of life?
¿La ayuda del abogado mejoró su calidad de vida?
¿Cómo la ayuda del abogado mejoró su calidad de vida?
As a result of the attorney's help, do you have more hope for the future?
¿Tengo más esperanza para el futuro?

Bankruptcy Outcomes: As a result of working with a VLN lawyer . . .

In the past two years, have you (check all that apply):
En últimos dos años, ha usted (Marque todas las que correspondan)
Was it helpful to have a volunteer work with you to gather documents that the attorney needed?
¿fue útil tener un trabajo voluntario con usted para reunir todos los documentos que el abogado necesitaba?
¿Hay algo que podríamos haber hecho mejor para ayudarlo a reunir su papeleo?
¿Cuánta deuda fue liberada?
What type of debt was included?
¿Qué tipo de deuda fue incluida?
Did the bankruptcy delay or prevent foreclosure of your home?
¿ La bancarrota retrasó o previno la ejecución hipotecaria de su casa?
Did the bankruptcy help you to recover funds that had been garnished?
¿La bancarrota ayudó a recuperar fondos que habían sido embargados?
Did the bankruptcy prevent the repossession of your car or other property?
¿La bancarrota evitó la recuperación de su carro o de otras propiedades?
Did the bankruptcy end creditor harassment?
¿La bancarrota terminó el acoso del acreedor?
Did the bankruptcy stop a pending lawsuit?
¿La bancarrota paró una demanda pendiente?
Have you been contacted by any creditors since receiving your discharge?
¿Ha sido contactado por algún acreedor desde que recibió su descargo?
Did the bankruptcy enable you to rebuild your credit?
¿La bancarrota le permite renovar su crédito?
Detalles (Si existen)
Are you more financially secure?
¿Está financieramente más seguro?
As a result of the bankruptcy, are you better able to support yourself and your family?
Como resultado de la bancarrota, ¿Es más capaz de mantenerse o mantener a su familia?
As a result of the bankruptcy, are you able to have your driver's license reinstated?
Como resultado de la bancarrota , ¿Es capaz de tener su licencia de conducir reestablecida?
Has filing for bankruptcy relief increased your access to credit?
Al declarase en quiebra , ¿ Ayudó al incremento de su acceso a créditos?
Do you have a better understanding of consumer credit?
¿Tiene una mejor comprensión del crédito de consumo?
Detalles (Si existen)

End

Formulario completado por

Changes to Form:

6/11/14 - changed client outcomes to matrix

8/14/14 - updated form that people completing by 9/15 will get a gift card (to be sent around 9/15)

10/16/14 - updated that people completing by 11/15 will get a gift card (to be sent around 11/15)

10/20/14 - updated to ask clients what other agencies they are being helped by (in case it helps us with selecting agencies with whom to partner)

12-17-14 - updated form that people completing by 12/31 will get a gift card (to be sent around 1/5/15)

1/10/15 - took out language about gift cards.

4/15/15 - added question about submitting a client photo for our conference room, etc.

4/28/15 - added question - do you have more hope for the future?

6/18/15 - hid the rest of the comparison follow up questions ("how" are things better).

8/27/15 - added the "three most important questions" to be consistent with advice questions.

8/7/20- removed area of law "housing" and added areas of law "Landlord-tenant" and "Real estate"


Dirección para enviar la tarjeta de regalo de Target (para ser enviado alrededor 9/15/14)

Description Area

7/2/15: Changed the outcome questions to make them shorter and easier, and added "protect other relationships." Took out all references to Target gift card.

8/1/15: added "did the attorney treat you well?"

5/1/16: changed "prevented a bad situation from becoming worse" to "prevented a bad outcome."

6/16/16: took out "you didn't help me with my problem" and "neither" from question 4 and added "Something else."

9/22/16: took out the conditional formatting logic that we provided Extensive services for the community advisory question to show.

4/3/17: added questions at the top "how likely to recommend VLN to a friend" and "why."

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