MACPRC Client Satisfaction Survey

General Information

All information is confidential and only utilized for assessing programming and services provided. Thank you for taking the time to fill out our survey. We rely on your feedback to help us improve our services. Your input is greatly appreciated.

Question Title

* 1. Date/Time

Date / Time

Date

Time

AM/PM

Question Title

* 2. How long have you been receiving services from Mineral Area CPRC Inc.?

1 Day-30 Days

More than 30 days less than 3 months

More than 3 months less than 6 months

More than 6 months less than 1 year

more than 1 year less than 3 years

More than 3 years less than 5 years

More than 5 years

Question Title

* 3. What services have you received from Mineral Area CPRC Inc. in the past 12 months? Check all that apply.

Psychiatric Care from Quentin Chambers PMHNP, MSN, RN or Gabe Crawford PMHNP,MSN, RN

PSR Clubhouse

Group Substance Use Counseling with Trish Bishop

Group Substance Use Counseling with Lisa Davidson

One-on-One Substance Use counseling with Trish Bishop

One-on-One Substance Use counseling with Lisa Davidson

Individual Sex Offender Therapy with Tonya Mills, LPC

Medication Management (Do you receive assistance with setting up your medications?)

Community Support Services (Case Management)

Peer Specialist

Medication Administration (Does a nurse at Mineral Area CPRC Inc. assist you by giving you an injectable medication on a regular basis?)

Other (please specify)

None of the above