Client Exit Survey Question Title * 1. Facility/Building accessibility? Poor Below Average Good Above average Excellent OK Question Title * 2. Facility/Building cleanliness? Poor Below Average Good Above Average Excellent OK Question Title * 3. Customer Service? Poor Below Average Good Above Average Excellent OK Question Title * 4. Are you made to feel welcome here? Poor Below Average Good Above Average Excellent OK Question Title * 5. Are you treated with dignity and respect? Poor Below Average Good Above Average Excellent OK Question Title * 6. Comments or Suggestions? OK Question Title * 7. Paperwork Process Poor Below Average Good Above Average Excellent OK Question Title * 8. Assessment? Poor Below Average Good Above Average Excellent OK Question Title * 9. Individual Counseling Services Poor Below Average Good Above Average Excellent OK Question Title * 10. Group Services ? Poor Below Average Good Above average Excellent OK Question Title * 11. Would you recommend EWC to others? If yes then please share how you felt this program impacted your treatment? Yes No Other (please specify) OK Question Title * 12. What do you like best about our program or services? OK Question Title * 13. What suggestions do you have to help us improve our program or services? OK Question Title * 14. Please rate our overall satisfaction with our services? Comment/Suggestions? Poor Below Average Good Above average Excellent Other (please specify) OK DONE