Thank you for taking the time to complete this brief, anonymous survey on your experience as a recent client. It is important to Nicasa Behavioral Health Services to continually build on what is working, make improvements, and reach out to anyone who may be in need of additional help. Please answer the following questions:

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* 1. Which service(s) did you receive from Nicasa Behavioral Health Services? (Please select all that apply)

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* 2. Are you currently experiencing problems in any of the following areas: use of alcohol and/or drugs, gambling behaviors, mental health concerns and/or overwhelming symptoms, and/or family relationships?

If yes, please describe below.

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* 3. Are you currently experiencing problems related to other important life areas (e.g. food, housing, employment, legal, etc.)?

If yes, please describe below.

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* 4. Overall, how satisfied were you with the services you received?

If you would like to speak to Nicasa Behavioral Health Services about any of the above, or about the services you received, please call (847)546-6450 or email info@nicasa.org.

 If you are experiencing a crisis or need immediate attention, please call 911 or visit the nearest urgent care center or emergency room.

Thank you for your feedback.

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