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Berks CSST Survey 2025 chance for a $10 gift card

Must give a valid Provider/Service.
Only postal address, no email address valid for gift card

A survey for Berks County residents with medical assistance (MA), who see a therapist, counselor, psychiatrist. You may skip questions.
Section 1) Provider and Service (ex. Haven Inpatient or Familicare Outpatient)
In general, is there anything negative or bad that you want to say about this service provider?
In general, is there anything positive or good that you want to say about this service provider?
Other services or providers you have (ex. SAM case manager, psychiatrist)
What is your age?
What is your gender?
What is your race?
What is your ethnicity?
Section 2) Service Access
Q2.2 In the last 12 months, were you able to get the services you needed?*
Q2.5 Have transportation problems ever been an issue for receiving services from this provider?
Section 3) Service Environment
Q3.1 Is the service environment safe and clean?
Q3.2 Do you feel your privacy/confidentiality is being respected by this provider?
Q3.3 Do you feel the staff understand and respect you with regard to cultural and personal experiences (gender, ethnicity, race, religion, sexuality)?
Section 4) Service Experience
Q4.3 In the last 12 months were you involved in making treatment decisions?*
Q4.4 Are your services with this provider helping you advance toward your goals?
If you or your child are under 21: 
Q4.7 Were family members involved in treatment planning decisions?
Section 5-6) Service Outcomes/Empowerment
Q5.1 Since this service began, my quality of life is:*
Q5.4 Did staff adequately explain your rights and responsibilities regarding your services or treatment?
Q5.6 Has this provider given you an anonymous means to express your opinions and concerns regarding your services?
Q5.7 If you could choose again, would you choose this provider for yourself?
Q6.6 Are you aware that there is a Complaint and Grievance Process you can use if necessary?
Section 8) Substance Use/Addiction - To help us better understand your experiences with substance use in the community, with your family, or even personally:
Q8.3 Addiction is a medical disease like diabetes, arthritis, or heart disease.
Q8.4 I would be embarrassed to tell people that someone close to me has a substance use disorder.
Neither agree nor disagree
Agree
Not applicable or prefer not to answer
Comments:
Gift card rules: To qualify, type your initials and a home address. No email. Must answer Q1 Where do you go for counseling, therapy, medication, or group support?