2015 Alliance Behavioral Healthcare Survey of Consumers and Family

1. Survey of Alliance Consumers and Family

Alliance Behavioral Healthcare is committed to the continuous improvement of the services offered to our residents with mental health, developmental disabilities, and substance use needs. We are conducting a needs assessment to understand what services you need that may be hard to get.

Please take a few minutes to complete this brief survey. Your responses are very important to help us understand the service needs in our community. The information that we receive through this process will inform our service planning and development efforts for the next year and will help us better serve adults, children, and families in our communities.

Please complete the survey by Friday, January 30.

Thank you!

Question Title

* 1. Please tell us which of the following describes you best:

Adolescent Consumer

Adult Consumer

Parent, other Family Member, or Guardian

Question Title

* 2. Please let us know the type of services you or your family member receive (select all that apply):

Child/Adolescent Mental Health

Child/Adolescent Developmental Disabilities

Child/Adolescent Substance Abuse

Adult Mental Health

Adult Developmental Disabilities

Adult Substance Abuse

Question Title

* 3. In which county do you live (parents, family and guardians: please indicate county of residence for consumer)?

Cumberland

Durham

Johnston

Wake

Other (please specify)