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Clarity - Wellsville Clinic - Participant Satisfaction Survey - July 2026

Your satisfaction with our agency is important to us.  Please provide us with your feedback by completing this survey (front and back) before you leave today, and return it to the front office staff or place it in our suggestion box.
 
On a scale of 1 – 5 please select the answer that best indicates how often you agree with the statement:
1.I am treated with courtesy and respect.
2.Phone calls are answered in a polite and respectful manner.
3.Phone calls are answered promptly.
4.I can speak with a “live” person when calling.
5.Overall, I am satisfied with office staff/receptionist.      
6.The interior/exterior appearance of the facility is inviting and clean.
7.The reception area is comfortable.
8.The reception area is clean.
9.Overall, I am satisfied with the facility.
10.Who is your counselor?
11.My counselor treats me with courtesy and respect.
12.I feel I have privacy when I meet with my counselor.
13.My questions and concerns are fully answered.
14.I am given the opportunity to explore my own needs and  interests.
15.My counselor is invested in helping me reach my goals.
16.Overall satisfaction with your counselor.
17.Medical Staff and Psychiatrist/Nurse Practitioner - Choose One
18.The medical provider treats me with courtesy and respect.
19.My questions and concerns are fully answered.
20.My symptoms are regularly monitored.
21.The effectiveness of my medication(s) is regularly monitored.
22.Overall, satisfaction with your medical provider.
23.I understand the services available to me.
24.Appointment times are convenient and flexible.
25.I understand how to access help after hours/weekends.
26.I would recommend this agency to family and friends.
27.I feel I have improved as a result of my services.
28.Who is your peer? (Put none if not enrolled in peer services)
29.My peer treats me with courtesy and respect.
30.I feel I have privacy when I meet with my peer
31.My peer works with me to achieve my goals
32.My peer works with me to explore my own needs and interests
33.Overall Satisfaction with your peer
34.What do we do well?
35.What could we do better?
36.What groups or other services are you interested in ?
37.If you could immediately change one thing about this agency, what would it be?
38.Optional - Would you like someone to contact  you regarding this survey
39.Optional - Your Information