Behavioral Health and Recovery Services (BHRS) Consumer Satisfaction Survey Question Title * 1. Date completed: Date Completed: Date Question Title * 2. Please check which program location you are receiving services: Merced Facility Livingston Facility Los Banos Facility Question Title * 3. Please check which program you are receiving services from: Behavioral Health Substance Use Disorder Both - Behavioral Health and Substance Use disorder Question Title * 4. For Behavioral Health services, please select the program you are enrolled in: Adult Older Adult Youth TAY AspiraNet Merced Lao Family Turning Point CSU Marie Green CARS COPE-CARS ISN-SIT CalWorks Creative Alternatives Central Star Residential Unit Central Star Youth CSU Rainbow Valley None Question Title * 5. For Substances Use Disorder, please the program you are enrolled in: Adult Drug Court CalWorks Center ODF Dependency Drug Court RAFT Perinatal None Demographics: Question Title * 6. Gender: Male Female Other Transgender Unknown/Not Reported Question Title * 7. Age: 0-15 16-25 26-59 60+ Question Title * 8. Race/Ethnicity: African American Asian Hispanic Multi-racial Native American Pacific Islander Punjabi White(non-Hispanic) Other (please specify) Survey Questions: Question Title * 9. Ease of Use: Strongly Agree Agree Disagree Strongly Disagree Don't Know Does Not Apply 1. It is easy to make an appointment. 1. It is easy to make an appointment. Strongly Agree 1. It is easy to make an appointment. Agree 1. It is easy to make an appointment. Disagree 1. It is easy to make an appointment. Strongly Disagree 1. It is easy to make an appointment. Don't Know 1. It is easy to make an appointment. Does Not Apply 2. The Location of services is convenient. 2. The Location of services is convenient. Strongly Agree 2. The Location of services is convenient. Agree 2. The Location of services is convenient. Disagree 2. The Location of services is convenient. Strongly Disagree 2. The Location of services is convenient. Don't Know 2. The Location of services is convenient. Does Not Apply 3. I am able to get all of the services I think I need. 3. I am able to get all of the services I think I need. Strongly Agree 3. I am able to get all of the services I think I need. Agree 3. I am able to get all of the services I think I need. Disagree 3. I am able to get all of the services I think I need. Strongly Disagree 3. I am able to get all of the services I think I need. Don't Know 3. I am able to get all of the services I think I need. Does Not Apply 4. Services are available at times that are good for me. 4. Services are available at times that are good for me. Strongly Agree 4. Services are available at times that are good for me. Agree 4. Services are available at times that are good for me. Disagree 4. Services are available at times that are good for me. Strongly Disagree 4. Services are available at times that are good for me. Don't Know 4. Services are available at times that are good for me. Does Not Apply 5. Staff returns my calls within 24 hours. 5. Staff returns my calls within 24 hours. Strongly Agree 5. Staff returns my calls within 24 hours. Agree 5. Staff returns my calls within 24 hours. Disagree 5. Staff returns my calls within 24 hours. Strongly Disagree 5. Staff returns my calls within 24 hours. Don't Know 5. Staff returns my calls within 24 hours. Does Not Apply Question Title * 10. Quality of Care: Strongly Agree Agree Disagree Strongly Disagree Don't Know Does Not Apply 6. I feel respected and listened to by staff. 6. I feel respected and listened to by staff. Strongly Agree 6. I feel respected and listened to by staff. Agree 6. I feel respected and listened to by staff. Disagree 6. I feel respected and listened to by staff. Strongly Disagree 6. I feel respected and listened to by staff. Don't Know 6. I feel respected and listened to by staff. Does Not Apply 7. I understand my treatment. 7. I understand my treatment. Strongly Agree 7. I understand my treatment. Agree 7. I understand my treatment. Disagree 7. I understand my treatment. Strongly Disagree 7. I understand my treatment. Don't Know 7. I understand my treatment. Does Not Apply 8. I feel comfortable asking questions about my treatment and/or medication. 8. I feel comfortable asking questions about my treatment and/or medication. Strongly Agree 8. I feel comfortable asking questions about my treatment and/or medication. Agree 8. I feel comfortable asking questions about my treatment and/or medication. Disagree 8. I feel comfortable asking questions about my treatment and/or medication. Strongly Disagree 8. I feel comfortable asking questions about my treatment and/or medication. Don't Know 8. I feel comfortable asking questions about my treatment and/or medication. Does Not Apply 9. I participate in my treatment planning. 9. I participate in my treatment planning. Strongly Agree 9. I participate in my treatment planning. Agree 9. I participate in my treatment planning. Disagree 9. I participate in my treatment planning. Strongly Disagree 9. I participate in my treatment planning. Don't Know 9. I participate in my treatment planning. Does Not Apply Question Title * 11. Outcomes: Strongly Agree Agree Disagree Strongly Disagree Don't Know Does Not Apply 10. My symptoms are not bothering me as much. 10. My symptoms are not bothering me as much. Strongly Agree 10. My symptoms are not bothering me as much. Agree 10. My symptoms are not bothering me as much. Disagree 10. My symptoms are not bothering me as much. Strongly Disagree 10. My symptoms are not bothering me as much. Don't Know 10. My symptoms are not bothering me as much. Does Not Apply 11. I am achieving my goals. 11. I am achieving my goals. Strongly Agree 11. I am achieving my goals. Agree 11. I am achieving my goals. Disagree 11. I am achieving my goals. Strongly Disagree 11. I am achieving my goals. Don't Know 11. I am achieving my goals. Does Not Apply 12. I do better in daily life. 12. I do better in daily life. Strongly Agree 12. I do better in daily life. Agree 12. I do better in daily life. Disagree 12. I do better in daily life. Strongly Disagree 12. I do better in daily life. Don't Know 12. I do better in daily life. Does Not Apply Question Title * 12. Overall Satisfaction: Strongly Agree Agree Disagree Strongly Disagree Don't Know Does Not Apply 13. I would recommend the services received at this agency to family and friends. 13. I would recommend the services received at this agency to family and friends. Strongly Agree 13. I would recommend the services received at this agency to family and friends. Agree 13. I would recommend the services received at this agency to family and friends. Disagree 13. I would recommend the services received at this agency to family and friends. Strongly Disagree 13. I would recommend the services received at this agency to family and friends. Don't Know 13. I would recommend the services received at this agency to family and friends. Does Not Apply 14. If I had other choices, I would still get services from this agency. 14. If I had other choices, I would still get services from this agency. Strongly Agree 14. If I had other choices, I would still get services from this agency. Agree 14. If I had other choices, I would still get services from this agency. Disagree 14. If I had other choices, I would still get services from this agency. Strongly Disagree 14. If I had other choices, I would still get services from this agency. Don't Know 14. If I had other choices, I would still get services from this agency. Does Not Apply 15. Comment: Thank you for telling us how we are doing! Done
