Thank you for taking the time to provide feedback. Your responses will assist in improving our services. 
 

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* 1. I am a (please select one option from the dropdown)

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* 2. When your student/child was admitted to the program were you contacted and given information regarding the specifics of the program?

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* 3. Were you included in the process of treatment planning and was/is the plan based upon your goals and your student's/child's goals?

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* 4. Did/do you feel your student/child was/is safe in the program?

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* 5. Did/are you and your student/child receive/receiving the services that you expected?

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* 6. Were you welcomed into the program and treated respectfully when calling or visiting your student/child?

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* 7. How accessible were/are staff members to addressing questions or concerns?

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* 8. How satisfied were/are you with how your questions and concerns were/are addressed? 

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* 9. Was/is there a specific staff member that you consider a reliable contact at the site? If so, please add their name here.

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* 10. Did you see positive changes in your student/child while in the program?

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* 11. Would you recommend this program to others?

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* 12. Additional comments....

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