* 1. What program do you participate in?

* 2. Length of time participated in program

* 3. Age

* 4. For each item below, indicate the number that best fits your level of agreement. 
Recovery refers to both mental health and substance use recovery.

  N/A Agree 5 4 3 2 Disagree 1
I am treated with dignity and respect
I feel safe when at NHTS or on the property
My privacy is respected by all staff
The program treats all people equally
People who work here are willing to answer my questions
People who work here care about what I think
The building is clean and well maintained
The rules and procedures at NHTS are fair
If something happens that I do not like, I know how to file a complaint
Admission to NHTS was easy
I know the goals in my treatment plan
I helped created the goals in my treatment plan
I am comfortable asking questions about my treatment and medication(s)
My counselor listens and cares about me
I am encouraged to get my family involved in treatment
I feel I am on a stable does of methadone or subutex.
The methadone/subutex dosing system works well
NHTS prescribes psychiatric medications which work for me
I feel that my doctor listens to me
I have made progress towards my recovery goals
I would recommend NHTS to others in need of treatment

* 5. What do you like the most about NHTS?

* 6. What would you like to see improve at NHTS?

* 7. Additional Comments

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