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Client survey

1.I was given written information about my rights and responsibilities as a consumer/client.
2.The people who work at the organization treat me with respect and courtesy.
3.The staff is respectful of my confidentiality and privacy.
4.The organization’s services are available at times that are good for me.
5.The organization’s building and offices are clean.
6.I feel safe while at the organization and on its property.
7.I help plan my services and set my goals.
8.If I needed help or services again I would come back to the organization.
9.Overall, I am satisfied with the services that I am receiving.
10.Demographic Information
11.Please use this space below to make additional comments about the organization and the services it provides. If you would like to speak with a member of the review team at the time of the site visit, please enter your name, phone number, the best time to call. NOTE: Please understand that the team may not contact you if evidence presented during the site visit does not require additional input.
Current Progress,
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