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* 1. Services which this feedback addresses: (choose all that apply)

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* 2. Please select your location

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* 3. Length of time it took to get my first appointment

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* 4. Front desk staff experience

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* 5. My provider is knowledgeable and helpful to me

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* 6. My treatment plan accurately addresses my needs

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* 7. Likelihood I would refer a friend or family member to TGC

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* 8. Overall staff is helpful and respectful to me

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* 9. Appointment availability fits my schedule:

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* 10. If you participated in Telehealth services, how satisfied were you?

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* 11. I would rate the overall quality of my care as

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* 12. Name of your Guidance Center treatment provider (optional)

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* 13. Your name (optional)

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* 14. Please explain your responses and/or comment on your overall experience at TGC.

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