Kansas Treatment Needs Asssesment Rev2

1. Background information

This page asks some basic background information about each person responding.

The State of Kansas is conducting an assessment of substance abuse treatment needs, using multiple indicators. These indicators involve National Household Survey data, admissionns' information, law enforcement and other data, as well as information from key informants such as you. Your information is confidential, and will only be shared in the context of statewide reports. The web survey is being hosted by DATACORP and PAXIS Institute, who are contractors involved with the needs assessment. Your feedback and information are crucial for helping with a legislative and policy agenda about the impact of substance abuse and related problems in Kansas.

Question Title

* 1. Please indicate the type of provider you are for substance abuse, mental health or related prroblems. Please choose the answer that best suits your circumstances.

Medical treatment entity

Psychologist in private practice

Agency of county or city

Psychiatrist in private practice

Agency with behavioral health or addictions treatment license

Residential substance abuse treatment entity

Residential psychiatric treatment entity

Licensed addiction professional in private practice

Contracted state provider for substance abuse or mental health

Faith-based agnecy or entity

Other (please specify)

Question Title

* 1. Please indicate the type of provider you are for substance abuse, mental health or related prroblems. Please choose the answer that best suits your circumstances.

Question Title

* 2. What is the county that you provide most of your services in? (If you service more than one county, please describe in the text box).