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  2. 2013
  3. May
  4. L
  5. L.A. County Children's Trauma Survey
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Exit Survey
 
 
1. Name
   
Executive Director
   
Address
   
Phone
   
Hours of Operation
   
Email
   
 
 
 
2. Executive Director
   
 
 
 
3. Address
   
 
 
 
4. Phone Number
   
 
 
 
5. Hours of Operation
   
 
 
 
6. Email Address
   
 
 
 
7. Do you take insurance?
 
Yes
 
No
 
 
 
8. If yes, what kind?
 
MediCal
 
Healthy Families
 
CVC
 
EPDST
 
Short Doyle
 
Kaiser
 
Other
 
 
 
 
9. Do you have a sliding scale?
 
Yes
 
No
 
 
 
10. If yes, please list sites: