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* 1. How many years have you known Concerted Care Group and/or Charm City Behavioral Health?

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* 2. Which location are you filling this survey out for?

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* 3. Are you employed in an organization that refers persons to our services?

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* 4. What kind of relationship with persons who have participated in our services do you have?

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* 5. When contacting us by phone, your call is answered in a prompt and courteous manner.

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* 6. Our employees return phone calls and/or answer email messages in a timely manner.

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* 7. Requests for information about our services, or about an individual receiving services, are responded to in a timely manner.

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* 8. I have been treated with respect each time I have had contact with your organization.

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* 9. Persons who request services, and meet the requirements for admission to a program, are admitted in a timely manner.

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* 10. Our organization treats all persons participating in services with respect.

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* 11. Our employees are sensitive to differences in the cultural backgrounds of the persons receiving services.

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* 12. Our organization encourages and is open to feedback about the quality of our services.

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* 13. Our organization is highly respected throughout the community for providing quality services.

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* 14. I would recommend your organization's services to a family member or friend, without hesitation.

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* 15. Accessibility to the program meets my expectations.

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* 16. Please provide any specific suggestions you may have for improving our organization and our services.

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* 17. Please provide any additional comments you may have related to your experience with our organization.

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