CMMHC Client Satisfaction Survey

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* 1. Where are your services located today? (please select only one option).

Buffalo

Elk River

Monticello

St Cloud

Waite Park

Tele-health

Home

Community

School (please specify)

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* 2. What service did you utilize today? (please select only one option).

Individual Therapy

Group Therapy

Psychiatry

Care Coordination

Day Treatment

Peers

Residential Crisis

Mobile Crisis

Crisis Phones

Co-Responder

Crisis Response Initiative (CRI)

Outpatient Substance Use Disorder (OPSUD)

Detox/ Withdrawal Management

Focus XII

Assertive Community Treatment (ACT)

Adult Rehabilitative Mental Health Services (ARMHS)

Community Support Program (CSP)/ AILS

Adult Targeted Case Management (TCM)

Child Targeted Case Management (TCM)

School Linked Mental Health (SLMH)

Children's Therapeutic Services and Supports (CTSS)

Early Intervention Family Services (EIFS)

Batters Intervention Program (BIP)

If you would like to comment on a specific service/ staff you saw today, please indicate below.

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* 3. Name of Provider Seen Today.

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* 4. At your visit today were staff helpful and friendly?

Yes

No (please specify)

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* 5. How long have you been using CMMHC services?

New client (first visit)

Less than 6 months

6-12 months

1-3 years

4+ years

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* 6. Which type of appointment do you prefer?

In-person appointments

Tele-health services

No preference

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* 7. What barriers cause you to cancel or miss your appointment(s)?

Technology (no internet/ phone/ device)

Transportation

Couldn't get off work/ school

Childcare

Legal

Sick

Emergency

Custody Issues

Payment

No appointment reminder

Provider Cancelled

No barriers

I don't miss/ cancel appointments

Other (please specify)

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* 8. How satisfied have you been with CMMHC's services in meeting your needs?

Not at all satisfied

Somewhat satisfied

Satisfied

Very Satisfied

Extremely Satisfied

Other (please specify)

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* 9. If CMMHC didn't meet your needs, please specify why.

Was not timely enough

Provider was not a good fit

Could not get necessary referrals/ placement

Accessibility needs

Language barriers

Transportation barriers

Tele-health barriers

Facility barriers

CMMHC met my needs

Other (please specify)

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* 10. Were your billing/ financial questions answered?

I don't have any billing/ financial questions

Yes

No (please specify)

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* 11. Can you tell us why you are no longer receiving services from CMMHC?

NA- still receiving services

I was feeling better

I was not able to make my appointments

The schedule did not work for me

Provider not a good fit

Completed programming

Receiving treatment elsewhere

Other (please specify)

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* 12. Would you refer a family member or friend to CMMHC?

Yes

No (please specify)

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* 13. What do your provider(s)/ care team do well?

Treated me with respect

Listened to what I had to say

Non-judgmental

Provided/ offered necessary resources

Provided/ offered necessary referrals

Met/ exceeded my needs and expectations

Controlled my symptoms with medication(s)

Saw me at a time/ place that was convenient

Care Coordination

Other (please specify)

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* 14. What could your provider(s) care team do better?

Treat me with respect

Listen to me

Don't judge me

Provide/ offer more resources

Provide/ offer more referrals

Get my symptoms under control with medication(s)

Offer evening/ weekend hours

Care Coordination

NA- no complaints

Nothing- CMMHC exceeds my expectations

Other (please specify)

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* 15. Would you like to be contacted about this survey?

Yes (please provide name and phone number)

CMMHC Client Satisfaction Survey

2024

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* 1. Where are your services located today? (please select only one option).

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* 2. What service did you utilize today? (please select only one option).

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* 3. Name of Provider Seen Today.

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* 4. At your visit today were staff helpful and friendly?

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* 5. How long have you been using CMMHC services?

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* 6. Which type of appointment do you prefer?

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* 7. What barriers cause you to cancel or miss your appointment(s)?

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* 8. How satisfied have you been with CMMHC's services in meeting your needs?

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* 9. If CMMHC didn't meet your needs, please specify why.

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* 10. Were your billing/ financial questions answered?

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* 11. Can you tell us why you are no longer receiving services from CMMHC?

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* 12. Would you refer a family member or friend to CMMHC?

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* 13. What do your provider(s)/ care team do well?

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* 14. What could your provider(s) care team do better?

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* 15. Would you like to be contacted about this survey?