*1.Who did you see?(Required.)

Triage Clinician

Psychiatrist

Therapist

Trainee

Group Therapist

Other (please specify)

2.Considering your experience with CAPS, how likely is it that you would recommend CAPS to someone you care about?

Very Likely

Likely

Neutral

Unliklely

Very unlikely

3.Did our team members (please select all that apply)

Connect with you politely

Introduce and explain their role

Communicate clearly about your care

Ask if you had any questions or concerns

Respond to your questions or concerns

Explain next steps

Demonstrate cultural sensitivity

All of the above

None of the above

4.Would you like to acknowledge a particular individual(s) involved with your care today?

5.Do you have any other specific feedback or suggestions about your visit today? (In order to protect your privacy, please do not include any personal health information, this is not an encrypted site)

6.This survey is anonymous. If you would like to be contacted, please provide your email address: