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* 1. Gender

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* 2. Race

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* 3. Time in Program

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* 4. Survey was completed with help from:

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* 5. Getting into the program was easy.

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* 6. I understand how the program works.

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* 7. People who work here care about what I think.

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* 8. There are several different ways to offer feedback about the program.

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* 9. I am treated with dignity and respect.

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* 10. My rights were clearly explained to me.

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* 11. If something happens that I don’t like, I know how to file a complaint.

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* 12. When I disclose my problems, I feel safe.

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* 13. I helped create the goals on my treatment plan.

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* 14. I review my treatment plan on a regular basis.

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* 15. I would recommend this program to my family and friends.

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* 16. I am encouraged to get my family and friends involved in treatment.

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* 17. My religious and spiritual beliefs/practices are respected.

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* 18. My counselor has a good understanding of my social and family background.

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* 19. I easily understand the staff when they are speaking to me.

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* 20. My beliefs about life and treatment are understood.

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* 21. I believe the organization values my personal health and safety .

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* 22. What do we do best?

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* 23. What is the one area we could most improve?

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* 24. What has improved since entering this program?

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