Consumer and Family Feedback
Consumer and Family Feedback Survey
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)
2.
Services were received for:
Adult
Youth
Myself
Adult family member
Youth family member
3.
I am/was satisfied with the services I or my family member received.
Yes
No
4.
I helped establish my treatment goals.
Yes
No
5.
I was able to have an appointment within two weeks of my request.
Yes
No
6.
I was given information about my rights.
Yes
No
7.
I was given a copy of the MHRS Board's Privacy Practices (HIPPA).
Yes
No
8.
I or my family member was able to get all the services I thought I needed.
Yes
No
9.
I or my family member needed the following services, but they were not available. Please Specify.
10.
Please comment on anything you think is being done very well:
11.
Please comment on anything that you think could be improved: