Consumer and Family Feedback Consumer and Family Feedback Survey Question Title * 1. I or a family member are receiving or have received services at the following agencies: Community Counseling Center Lake Area Recovery Center Signature Health Inc. Catholic Charities Family Pride Cadence Care Other (please specify) Question Title * 2. Services were received for: Adult Youth Myself Adult family member Youth family member Question Title * 3. I am/was satisfied with the services I or my family member received. Yes No Question Title * 4. I helped establish my treatment goals. Yes No Question Title * 5. I was able to have an appointment within two weeks of my request. Yes No Question Title * 6. I was given information about my rights. Yes No Question Title * 7. I was given a copy of the MHRS Board's Privacy Practices (HIPPA). Yes No Question Title * 8. I or my family member was able to get all the services I thought I needed. Yes No Question Title * 9. I or my family member needed the following services, but they were not available. Please Specify. Question Title * 10. Please comment on anything you think is being done very well: Question Title * 11. Please comment on anything that you think could be improved: Done
