Consumer Satisfaction Survey Fall 2021

CLIENT SATISFACTION SURVEY

We are committed to offering the best services possible. In order to evaluate our services we need your help by taking a few minutes to answer the following questions and giving us any comments about your experience with us.

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* 1. According to our records, you had services recently. Please select your providers name from the list below, and tell us your opinion about the service you received. Your responses will be kept strictly confidential, unless you would like a supervisor to contact you regarding your feedback. We thank you for taking time to let us know how we are meeting your needs.

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* 2. Employee Department (Internal Use Only)

MED

CBS

SBS

SDA

CSS

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* 3. I AM:

the consumer

the parent, guardian or representative of the consumer

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* 4. HOW DID YOU HAPPEN TO COME TO HORIZONS:

on my own

court ordered

recommended by others

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* 5. RECEIVING SERVICES FOR HOW LONG:

less than 6 months

6 months - 1 year

1 - 3 years

3 - 5 years

more than 5 years

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* 6. RECEIVED SERVICES AT:

Hutchinson

Kingman

Pratt

Anthony

Medicine Lodge

Other (please specify)

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* 7. YOUR APPOINTMENTS

	Stongly Agree	Agree	Neutral	Poor	Very Poor	Does Not Apply in last 6 months
Received your first appointment within a reasonable amount of time	Received your first appointment within a reasonable amount of time Stongly Agree	Received your first appointment within a reasonable amount of time Agree	Received your first appointment within a reasonable amount of time Neutral	Received your first appointment within a reasonable amount of time Poor	Received your first appointment within a reasonable amount of time Very Poor	Received your first appointment within a reasonable amount of time Does Not Apply in last 6 months
Follow up appointments were easy to make	Follow up appointments were easy to make Stongly Agree	Follow up appointments were easy to make Agree	Follow up appointments were easy to make Neutral	Follow up appointments were easy to make Poor	Follow up appointments were easy to make Very Poor	Follow up appointments were easy to make Does Not Apply in last 6 months
Appointments available at a convenient time	Appointments available at a convenient time Stongly Agree	Appointments available at a convenient time Agree	Appointments available at a convenient time Neutral	Appointments available at a convenient time Poor	Appointments available at a convenient time Very Poor	Appointments available at a convenient time Does Not Apply in last 6 months

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* 8. TELEHEALTH APPOINTMENTS

	Stongly Agree	Agree	Neutral	Poor	Very Poor	Does Not Apply in last 6 months
I could clearly communicate with my provider during the visit	I could clearly communicate with my provider during the visit Stongly Agree	I could clearly communicate with my provider during the visit Agree	I could clearly communicate with my provider during the visit Neutral	I could clearly communicate with my provider during the visit Poor	I could clearly communicate with my provider during the visit Very Poor	I could clearly communicate with my provider during the visit Does Not Apply in last 6 months
Overall I am satisfied with telehealth and found it helpful	Overall I am satisfied with telehealth and found it helpful Stongly Agree	Overall I am satisfied with telehealth and found it helpful Agree	Overall I am satisfied with telehealth and found it helpful Neutral	Overall I am satisfied with telehealth and found it helpful Poor	Overall I am satisfied with telehealth and found it helpful Very Poor	Overall I am satisfied with telehealth and found it helpful Does Not Apply in last 6 months
I would prefer to use telehealth over traditional office services	I would prefer to use telehealth over traditional office services Stongly Agree	I would prefer to use telehealth over traditional office services Agree	I would prefer to use telehealth over traditional office services Neutral	I would prefer to use telehealth over traditional office services Poor	I would prefer to use telehealth over traditional office services Very Poor	I would prefer to use telehealth over traditional office services Does Not Apply in last 6 months

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* 9. THE COURTESY & HELPFULNESS OF OUR STAFF

	Excellent	Very Good	Good	Fair	Poor	Does Not Apply in last 6 months
The person who took your call	The person who took your call Excellent	The person who took your call Very Good	The person who took your call Good	The person who took your call Fair	The person who took your call Poor	The person who took your call Does Not Apply in last 6 months
The person who checked you in or assisted with paperwork	The person who checked you in or assisted with paperwork Excellent	The person who checked you in or assisted with paperwork Very Good	The person who checked you in or assisted with paperwork Good	The person who checked you in or assisted with paperwork Fair	The person who checked you in or assisted with paperwork Poor	The person who checked you in or assisted with paperwork Does Not Apply in last 6 months
The person who assisted you with billing or insurance	The person who assisted you with billing or insurance Excellent	The person who assisted you with billing or insurance Very Good	The person who assisted you with billing or insurance Good	The person who assisted you with billing or insurance Fair	The person who assisted you with billing or insurance Poor	The person who assisted you with billing or insurance Does Not Apply in last 6 months
The person who helped you with Releases of Information	The person who helped you with Releases of Information Excellent	The person who helped you with Releases of Information Very Good	The person who helped you with Releases of Information Good	The person who helped you with Releases of Information Fair	The person who helped you with Releases of Information Poor	The person who helped you with Releases of Information Does Not Apply in last 6 months

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* 10. OUR COMMUNICATION WITH YOU

	Stongly Agree	Agree	Neutral	Poor	Very Poor	Does Not Apply in last 6 months
Your phone calls answered promptly	Your phone calls answered promptly Stongly Agree	Your phone calls answered promptly Agree	Your phone calls answered promptly Neutral	Your phone calls answered promptly Poor	Your phone calls answered promptly Very Poor	Your phone calls answered promptly Does Not Apply in last 6 months
You were able to get advice or help when needed, during office hours	You were able to get advice or help when needed, during office hours Stongly Agree	You were able to get advice or help when needed, during office hours Agree	You were able to get advice or help when needed, during office hours Neutral	You were able to get advice or help when needed, during office hours Poor	You were able to get advice or help when needed, during office hours Very Poor	You were able to get advice or help when needed, during office hours Does Not Apply in last 6 months
Your calls were returned in a timely manner	Your calls were returned in a timely manner Stongly Agree	Your calls were returned in a timely manner Agree	Your calls were returned in a timely manner Neutral	Your calls were returned in a timely manner Poor	Your calls were returned in a timely manner Very Poor	Your calls were returned in a timely manner Does Not Apply in last 6 months
You were able to get help if you had an emergency at night or on the weekends	You were able to get help if you had an emergency at night or on the weekends Stongly Agree	You were able to get help if you had an emergency at night or on the weekends Agree	You were able to get help if you had an emergency at night or on the weekends Neutral	You were able to get help if you had an emergency at night or on the weekends Poor	You were able to get help if you had an emergency at night or on the weekends Very Poor	You were able to get help if you had an emergency at night or on the weekends Does Not Apply in last 6 months

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* 11. YOUR VISIT WITH THE PROVIDER

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Does Not Apply
They were willing to listen carefully to your opinions and ideas	They were willing to listen carefully to your opinions and ideas Strongly Agree	They were willing to listen carefully to your opinions and ideas Agree	They were willing to listen carefully to your opinions and ideas Neutral	They were willing to listen carefully to your opinions and ideas Disagree	They were willing to listen carefully to your opinions and ideas Strongly Disagree	They were willing to listen carefully to your opinions and ideas Does Not Apply
Explained things in a way you could understand	Explained things in a way you could understand Strongly Agree	Explained things in a way you could understand Agree	Explained things in a way you could understand Neutral	Explained things in a way you could understand Disagree	Explained things in a way you could understand Strongly Disagree	Explained things in a way you could understand Does Not Apply
Involved you in developing a meaningful treatment plan and goals	Involved you in developing a meaningful treatment plan and goals Strongly Agree	Involved you in developing a meaningful treatment plan and goals Agree	Involved you in developing a meaningful treatment plan and goals Neutral	Involved you in developing a meaningful treatment plan and goals Disagree	Involved you in developing a meaningful treatment plan and goals Strongly Disagree	Involved you in developing a meaningful treatment plan and goals Does Not Apply
Took the time to answer your questions	Took the time to answer your questions Strongly Agree	Took the time to answer your questions Agree	Took the time to answer your questions Neutral	Took the time to answer your questions Disagree	Took the time to answer your questions Strongly Disagree	Took the time to answer your questions Does Not Apply
Took an adequate amount of time with you	Took an adequate amount of time with you Strongly Agree	Took an adequate amount of time with you Agree	Took an adequate amount of time with you Neutral	Took an adequate amount of time with you Disagree	Took an adequate amount of time with you Strongly Disagree	Took an adequate amount of time with you Does Not Apply

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* 12. OUR FACILITY

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Does Not Apply
Location is easily accessible	Location is easily accessible Strongly Agree	Location is easily accessible Agree	Location is easily accessible Neutral	Location is easily accessible Disagree	Location is easily accessible Strongly Disagree	Location is easily accessible Does Not Apply
Adequate parking	Adequate parking Strongly Agree	Adequate parking Agree	Adequate parking Neutral	Adequate parking Disagree	Adequate parking Strongly Disagree	Adequate parking Does Not Apply
Hours of operation convenient for you	Hours of operation convenient for you Strongly Agree	Hours of operation convenient for you Agree	Hours of operation convenient for you Neutral	Hours of operation convenient for you Disagree	Hours of operation convenient for you Strongly Disagree	Hours of operation convenient for you Does Not Apply
Horizons has been a comfortable place to receive services	Horizons has been a comfortable place to receive services Strongly Agree	Horizons has been a comfortable place to receive services Agree	Horizons has been a comfortable place to receive services Neutral	Horizons has been a comfortable place to receive services Disagree	Horizons has been a comfortable place to receive services Strongly Disagree	Horizons has been a comfortable place to receive services Does Not Apply

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* 13. YOUR OVERALL SATISFACTION

	Excellent	Very Good	Good	Fair	Poor
Core Values are the foundation of who we are and what we strive to be. How did our staff do in following our Core Values: Integrity - Compassion - Accountability - Respect - Excellence	Core Values are the foundation of who we are and what we strive to be. How did our staff do in following our Core Values: Integrity - Compassion - Accountability - Respect - Excellence Excellent	Core Values are the foundation of who we are and what we strive to be. How did our staff do in following our Core Values: Integrity - Compassion - Accountability - Respect - Excellence Very Good	Core Values are the foundation of who we are and what we strive to be. How did our staff do in following our Core Values: Integrity - Compassion - Accountability - Respect - Excellence Good	Core Values are the foundation of who we are and what we strive to be. How did our staff do in following our Core Values: Integrity - Compassion - Accountability - Respect - Excellence Fair	Core Values are the foundation of who we are and what we strive to be. How did our staff do in following our Core Values: Integrity - Compassion - Accountability - Respect - Excellence Poor
Overall quality of care and services	Overall quality of care and services Excellent	Overall quality of care and services Very Good	Overall quality of care and services Good	Overall quality of care and services Fair	Overall quality of care and services Poor
Degree to which treatment helped you deal with your problem/ complaint	Degree to which treatment helped you deal with your problem/ complaint Excellent	Degree to which treatment helped you deal with your problem/ complaint Very Good	Degree to which treatment helped you deal with your problem/ complaint Good	Degree to which treatment helped you deal with your problem/ complaint Fair	Degree to which treatment helped you deal with your problem/ complaint Poor
Degree to which services have supported my efforts to become more self-sufficient	Degree to which services have supported my efforts to become more self-sufficient Excellent	Degree to which services have supported my efforts to become more self-sufficient Very Good	Degree to which services have supported my efforts to become more self-sufficient Good	Degree to which services have supported my efforts to become more self-sufficient Fair	Degree to which services have supported my efforts to become more self-sufficient Poor

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* 14. WOULD YOU RECOMMEND OUR SERVICES TO OTHERS?

Yes

If no, please share why:

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* 15. COMMENTS YOU WOULD LIKE TO PROVIDE US ABOUT YOUR SERVICES:

Thank you for taking time to provide us with feedback regarding how Horizons Mental Health Center is meeting your needs.