Please take a moment to complete this client satisfaction survey regarding our Crisis Services, thank you!

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* 1. Date

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* 2. Your Name: (Optional)

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* 3. Crisis Staff’s Name(s):

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* 4. Location you (or your child) received crisis services:

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* 5. Please rate the Crisis Staff’s ability to: Understand your (or your child’s) main concerns

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* 6. Please rate the Crisis Staff’s ability to: Explain what SASS is and ‘what’s next’ for your (or your child’s) treatment

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* 7. Please rate the Crisis Staff’s attention to: positive supports (such as family members, friends, activities etc.) to you (or your child) when creating the safety plan

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* 8. I (and/or my child) were treated with respect throughout the assessment.

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* 9. I (and/or my child) were treated with respect during aftercare and follow-ups from SASS.

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* 10. How likely are you to recommend FSA to others?

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* 11. Please provide any additional suggestions or comments regarding your overall experience with FSA:

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