We would like to know how you feel overall about the services we provide, so we can make sure we are meeting your needs. Your response will help us improve our services. There is no right or wrong answer. We are asking for your honest opinions. In no way will your responses affect your treatment here. Please fill out the survey only once using this Survey Monkey link.  Thank you for your time!

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* 1. Please enter today's date

Date

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* 2. What services have you used this year?

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* 3. Put a check in the box below that best describes how much you agree or disagree with each statement. Mark N/A if the statement is not applicable to you.

  Strongly Agree Agree Neutral Disagree Strongly Disagree N/A
I know what is on my treatment plan, and it works for me, because I helped make it.
Staff answer my questions or help me find answers.
I feel supported and respected as a person by staff.
Overall, I am satisfied with the services I receive at the Norfolk CSB.
I would recommend the Norfolk CSB to my family and friends if they needed services.

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* 4. Would you like to tell us anything else today about the NCSB?

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