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* 1. I would like the option of continuing telehealth services, at least for a portion of my services at CoveCare Center: 

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* 2. Without telehealth, I would not have continued services at CoveCare Center:

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* 3. I feel my needs can be adequately addressed through telehealth services:

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* 4. I like the following things about telehealth (you can select more than one choice):

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* 5. I do NOT like the following things about telehealth:

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* 6. Please briefly mention any ways that telehealth could be improved:

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* 7. I would like to use Zoom:

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* 8. I feel respected by staff when I am in contact with CoveCare Center for services:

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* 9. When in need of services outside of the agency hours, I have been satisfied with the help from the CoveCare Center Crisis Line:

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* 10. Services from CoveCare Center have helped me to better deal with the issues that brought me here:

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* 11. Gender:

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* 12. Age:

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* 13. Please check this box if you are filling out this survey for a minor

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* 14. How long have you been using services at CoveCare Center?

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* 15. Please check ALL of the services that you have used at CoveCare Center in the past year:

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* 16. Please list any suggested improvements that you have about the services you receive at CoveCare Center.  If you "disagreed" or "strongly disagreed" with any statement on the survey, please let us know why:

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