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2026 CCH&WC - BH Patient Satisfaction Survey

1.What is your gender?
2.What is your age?
3.What is your race and/or ethnicity? (Select all that apply)
4.How did you hear about our office?
5.Which provider were you scheduled with/for today?
6.Overall, how satisfied are you with the treatment you received?
7.Would you recommend this program to someone seeking mental health or substance use treatment?
8.Did this program meet your expectations?
9.How satisfied were you with how easy it was to get an appointment or admission?
10.How satisfied were you with the respect and dignity shown to you by staff?
11.How satisfied were you with how well your provider(s) listened to your concerns?
12.How satisfied were you with staff’s understanding of your mental health or substance use challenges?
13.How satisfied were you with your understanding of your treatment plan and goals?
14.How satisfied were you with your involvement in decisions about your treatment?
15.How satisfied were you with how helpful and relevant therapy sessions were to your needs?
16.If medications were part of your treatment, how satisfied were you with how well they were explained (including benefits and side effects)?
17.How satisfied were you with your sense of emotional and physical safety in the program?
18.How satisfied were you with the program’s support of your recovery goals and the coping skills/tools you gained?
19.Additional Comments (Optional)
Please share any additional feedback about your experience: