CLIENT SATISFACTION SURVEY- 2023-2024

By completing the questions below, you will support our Performance Improvement Activities thus allowing us to provide better services and improved business practices Your answers are confidential and will not influence your treatment in any manner.  Put a cross (X) in the box that best describes your answer. Thank you!!!
1.Location(Required.)
2.What is your gender?(Required.)
3.Which of the following categories best describes your employment status?(Required.)
4.Program:
5.Time in Program(Required.)
6.Living Arrangements(Required.)
7.What is your age?(Required.)
8.Health Insurance(Required.)
9.Access/Admission/Orientation(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
I was admitted to the program in a reasonable amount of time.
I reviewed and was provided a Handbook (Guide to Services) that explained the program rules, program limitations, as well as financial responsibilities including billing, no show policy, and insurance information.
The Mission, Values, and Goals of the Program were explained to me.
10.Referrals, Transition and/or Discharge(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
I was provided with relevant community referrals when I asked for them or as the staff became aware of my need.
If a level of care change or other type of Transition occurred, I was informed and participated in this change
11.Input from Persons Served(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
People who work here seem interested in my progress and the services provided.
I am encouraged to give my opinion about my treatment, the staff, as well as the program and services.
There are several different ways to offer feedback about the program (suggestion box, satisfaction survey, online survey, etc.).
12.Rights and Responsibilities(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
My rights and responsibilities were clearly explained to me and I was offered a copy for my records.
If something happens that I don’t like or I feel like my rights have been violated, I know how to file a complaint or a grievance
Duty to Warn and Limits to Confidentiality were explained to me.
13.The Assessment Process(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
My needs were identified and discussed with an educated and respectful staff member.
I felt heard, listened to, and safe when disclosing my reasons for seeking services. 
I felt respected when sharing my history and developing a plan for services.
14.Treatment Planning(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
I participated in the development of my treatment plan and/or was offered a copy
I signed and reviewed my treatment goals and objectives on a regular basis
My treatment plan is revised or updated when things change or at my request.
15.Quality of Care(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
I would recommend the services I was provided to my family and friends.
The staff seem educated and competent when providing care.
The staff discussed with me and provided me with relevant and current therapeutic interventions while I was receiving services.
The environment and energy of the facility felt welcoming, professional, private, and safe.
I am encouraged to include family and/or my other support systems when engaging in services.
16.Quality of Life(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
My overall Quality of Life has improved since beginning services.
I am doing better in school, work, and/or other daily activities
My personal relationships, family relationships, and/or support system dynamic has improved.
I am more self-aware and better at managing my Mental Health needs.
17.Cultural Competency(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
My religious or spiritual beliefs and/or practices are respected.
The staff has a professional understanding of my educational, social, socioeconomic, and family background.
The staff seemed self-aware, displayed an open attitude including knowledge and skills, and appeared open toward others.
18.Accessibility and Technology(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
The building and location are easily accessible for my needs.
My request for Reasonable Accommodations was taken seriously and met my needs.
Telehealth Services were simple to understand and use. 
Using the Phone System including Voicemail or ability to contact staff was simple and current with common technology standards
Searching the website for location, contact information, services available, hours of operation, or performance outcome measures was easily accessible.
19.Health and Safety(Required.)
Strongly Disagree
Disagree
Agree
Strongly Agree
Does not Apply 
Services are provided in a clean and sanitary facility
I believe the organization values my personal health and safety by implementing policies that do NOT permit weapons, tobacco, alcohol, and other illicit or illegal drugs on the premises, at agency-sponsored events, or on an agency-owned property.
In the event of an emergency, while receiving services or while at the facility, I can access health and safety information for safe evacuation or other emergency situations.
20.What has been the most helpful thing about the services you received?
21.What would improve the services here?