Behavioral Health Services
Client Discharge Satisfaction Survey

Client Discharge Satisfaction Survey

We would like to know how you feel about the services we provide so we can make sure we are meeting your needs.  Your responses directly impact our improvement, and will be confidential and anonymous.  Thank you for your time.
1.Please Rate the Following Based on Your Care, Treatment, and Services
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
I found the waiting room environment was comfortable and/or appropriate.
I found the front office staff was welcoming and helpful for my needs.
Staff worked with me in setting up appointments.
I was treated with respect by staff.
Staff were helpful in dealing with billing/fee establishment procedures.
I found that my counselor's office created a pleasant environment for sessions.
I found that the group room was a pleasant environment for group treatment.
I felt my counselor listened to me in individual sessions and that I could talk about anything I needed to share.
I was able to gain healthier coping skills to handle high risk situations and/or feelings.
I was given information about resources available in the community.
2.Please Rate the Following Based on Your Treatment Plan
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
I had input in developing my treatment plan and understood the direction my counseling was going in.
I understand the level of care that was recommended during my treatment.
I was able to gain a better understanding of addiction during my treatment.
Staff offered to involve my family in treatment.
I was asked about my treatment goals and needs.
I was asked if my treatment goals and needs were met.
I found my groups to be helpful during my treatment. 
3.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
4.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
5.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
6.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
7.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
8.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
9.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
10.Evaluate Each Group Attended
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Evaluate Group Attended
11.Mental Health Section:
5
Strongly Agree
4
Agree
3
Neutral
2
Disagree
1
Strongly Disagree
N/A
Were you assessed for co-occurring issues? (Anxiety, Depression, etc.)  If so, were your needs met?
Did you receive co-occurring education/information? If so was the education/information helpful?
Did you receive or were you referred for mental health treatment?  If so, were your needs met?
Are you on medication for mental health issues?  If so, was it helpful?
Overall, I was satisfied with services received for co-occuring (mental health/substance use disorder) issues?
12.List any suggestions for improving the safety of the care, treatment, or services provided to you at Access Carroll:
13.List 3 things that were most helpful in your treatment:
14.OPTIONAL: List your Behavioral Health Providers Name(s):
15.OPTIONAL: Provide Your Name Below:
Current Progress,
0 of 15 answered