Cascadia Health Client Survey

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* 1. Race (choose one):

Alaska Indian or Alaska Native

American Indian

Asian

Black or African American

White

Native Hawaiian or Pacific Islander

Two or more races

Prefer not to identify

Self-Identify:

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* 2. Ethnicity (choose one):

Puerto Rican

Mexican

Cuban

Hispanic

Latino or Latina or Latinx

Not of Hispanic or Latino or Latina or Latinx Origin

Unknown

Self-Identify:

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* 3. Location (choose one):

Community

Clackamas

Garlington

Woodland Park

Plaza

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* 4. What kind of services are you receiving? Choose all that apply:

Mental Health

Addiction Treatment

Primary Care

Housing

Support

Urgent Walk-In

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* 5. If you travel to a Cascadia location, is it easy for you to get to? Choose one:

Yes

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* 6. If you travel to a Cascadia location for services, are the service hours meeting your needs? Choose one:

Yes

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* 7. If Cascadia’s current hours and days of operation do not meet your needs, what days and times would work better for you? For example: Saturday evenings, 5:00-8:00 p.m.

Please write in some options:

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* 8. How do you get to your appointment? Choose all that apply:

Drive self

Bus/MAX

Medical Transportation Service

Ride from family/friend

Uber/Lyft/Taxi

Staff come to you

Walk

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* 9. In the last year has Cascadia given you a bus/MAX ticket so you could attend an appointment? Choose one:

Yes

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* 10. If you have called or emailed your Cascadia doctor or counselor, how many days did you wait before receiving a response? Circle the best answer:

Same day

1-2 days

3-4 days

5 or more days

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* 11. After calling or emailing for an appointment, in how many days are you given an appointment? Circle the best answer:

Same day

1-2 day

3-4 days

5 or more days

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* 12. Please answer the following questions by choosing the ranking that best meets your selection:

	Strongly Disagree	Disagree	Agree	Strongly Agree
I found it easy to access or enter into services at Cascadia.	I found it easy to access or enter into services at Cascadia. Strongly Disagree	I found it easy to access or enter into services at Cascadia. Disagree	I found it easy to access or enter into services at Cascadia. Agree	I found it easy to access or enter into services at Cascadia. Strongly Agree	I found it easy to access or enter into services at Cascadia.
I feel that I am treated with respect by Cascadia staff.	I feel that I am treated with respect by Cascadia staff. Strongly Disagree	I feel that I am treated with respect by Cascadia staff. Disagree	I feel that I am treated with respect by Cascadia staff. Agree	I feel that I am treated with respect by Cascadia staff. Strongly Agree	I feel that I am treated with respect by Cascadia staff.
I feel the waiting rooms are welcoming and friendly.	I feel the waiting rooms are welcoming and friendly. Strongly Disagree	I feel the waiting rooms are welcoming and friendly. Disagree	I feel the waiting rooms are welcoming and friendly. Agree	I feel the waiting rooms are welcoming and friendly. Strongly Agree	I feel the waiting rooms are welcoming and friendly.
I feel that Cascadia is responsive to my cultural needs.	I feel that Cascadia is responsive to my cultural needs. Strongly Disagree	I feel that Cascadia is responsive to my cultural needs. Disagree	I feel that Cascadia is responsive to my cultural needs. Agree	I feel that Cascadia is responsive to my cultural needs. Strongly Agree	I feel that Cascadia is responsive to my cultural needs.
I feel that Cascadia is helping me with making progress towards my treatment goals/needs.	I feel that Cascadia is helping me with making progress towards my treatment goals/needs. Strongly Disagree	I feel that Cascadia is helping me with making progress towards my treatment goals/needs. Disagree	I feel that Cascadia is helping me with making progress towards my treatment goals/needs. Agree	I feel that Cascadia is helping me with making progress towards my treatment goals/needs. Strongly Agree	I feel that Cascadia is helping me with making progress towards my treatment goals/needs.
If I have a concern about my treatment or how I am being treated, I know where to go in Cascadia to address my concerns.	If I have a concern about my treatment or how I am being treated, I know where to go in Cascadia to address my concerns. Strongly Disagree	If I have a concern about my treatment or how I am being treated, I know where to go in Cascadia to address my concerns. Disagree	If I have a concern about my treatment or how I am being treated, I know where to go in Cascadia to address my concerns. Agree	If I have a concern about my treatment or how I am being treated, I know where to go in Cascadia to address my concerns. Strongly Agree	If I have a concern about my treatment or how I am being treated, I know where to go in Cascadia to address my concerns.
I would recommend Cascadia services to others	I would recommend Cascadia services to others Strongly Disagree	I would recommend Cascadia services to others Disagree	I would recommend Cascadia services to others Agree	I would recommend Cascadia services to others Strongly Agree	I would recommend Cascadia services to others

Cascadia Health Client Survey

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* 1. Race (choose one):

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* 2. Ethnicity (choose one):

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* 3. Location (choose one):

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* 4. What kind of services are you receiving? Choose all that apply:

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* 5. If you travel to a Cascadia location, is it easy for you to get to? Choose one:

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* 6. If you travel to a Cascadia location for services, are the service hours meeting your needs? Choose one:

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* 7. If Cascadia’s current hours and days of operation do not meet your needs, what days and times would work better for you? For example: Saturday evenings, 5:00-8:00 p.m.Please write in some options:

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* 8. How do you get to your appointment? Choose all that apply:

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* 9. In the last year has Cascadia given you a bus/MAX ticket so you could attend an appointment? Choose one:

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* 10. If you have called or emailed your Cascadia doctor or counselor, how many days did you wait before receiving a response? Circle the best answer:

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* 11. After calling or emailing for an appointment, in how many days are you given an appointment? Circle the best answer:

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* 12. Please answer the following questions by choosing the ranking that best meets your selection:

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* 13. Do you have any other feedback you would like to give Cascadia?

* 7. If Cascadia’s current hours and days of operation do not meet your needs, what days and times would work better for you? For example: Saturday evenings, 5:00-8:00 p.m.

Please write in some options: