Client Satisfaction Survey
1.
Gender
Male
Female
Transgender
2.
Race
African American
Caucasian
Hispanic
Asian
Native American
Indian
Arabic
Other
3.
Time in Program
Less then 3 months
3, 4, 5 months
6, 7, 8 months
9, 10, 11 months
1 year or more
2 years or more
4.
Survey was completed with help from:
Help from no one
Help from a staff member
Help from a friend
Help from a family member
5.
Getting into the program was easy.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
6.
I understand how the program works.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
7.
People who work here care about what I think.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
8.
There are several different ways to offer feedback about the program.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
9.
I am treated with dignity and respect.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
10.
My rights were clearly explained to me.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
11.
If something happens that I don’t like, I know how to file a complaint.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
12.
When I disclose my problems, I feel safe.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
13.
I helped create the goals on my treatment plan.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
14.
I review my treatment plan on a regular basis.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
15.
I would recommend this program to my family and friends.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
16.
I am encouraged to get my family and friends involved in treatment.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
17.
My religious and spiritual beliefs/practices are respected.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
18.
My counselor has a good understanding of my social and family background.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
19.
I easily understand the staff when they are speaking to me.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
20.
My beliefs about life and treatment are understood.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
21.
I believe the organization values my personal health and safety .
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
22.
What do we do best?
23.
What is the one area we could most improve?
24.
What has improved since entering this program?
Current Progress,
0 of 24 answered