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CLIENT SATISFACTION SURVEY
Your opinion about the quality of service you have received from Rim Family Services, Inc. is important to us. Thank you for completing this survey.
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1.
My initial phone call was answered promptly and politely.
(Required.)
Yes
No
N/A
*
2.
I participated in the following program(s):
(Required.)
Community Event
DUI/PC1000
Groups (Support, Education, Etc.)
Therapy/Counseling
Other (please specify)
*
3.
The location of my program/service was convenient for me.
(Required.)
Yes
No
*
4.
On my first contact with RFS, I was greeted promptly and politely.
(Required.)
Yes
No
5.
Ethnic background (response is optional).
Caucasian
Native American
African American
Hispanic/Latino
Asian
Other (please specify)
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6.
Services Received
(Required.)
Yes
No
I was able to obtain all the services I needed.
Yes
No
Staff believed I could grow and change.
Yes
No
I felt safe and able to ask questions.
Yes
No
My initial service was handled in a professional manner.
Yes
No
The service I received was helpful.
Yes
No
I was treated with respect by staff.
Yes
No
I had confidence in my primary staff members' knowledge and skills.
Yes
No
My expectations for getting help were met.
Yes
No
Staff were sensitive to my cultural/ethnic background.
Yes
No
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7.
Services Received (Continued)
(Required.)
Yes
No
N/A
Staff helped me so I could manage my life and change/recover.
Yes
No
N/A
Staff made sure sessions, groups or home visits started on time.
Yes
No
N/A
My primary counselor/therapist/educator and I worked together to plan my treatment/program.
Yes
No
N/A
The staff explained the payment process to me.
Yes
No
N/A
The staff helped me with my payment plan.
Yes
No
N/A
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8.
I felt my confidentiality was kept.
(Required.)
Yes
No
*
9.
Services were available to me at times that were convenient.
(Required.)
Yes
No
*
10.
Please rate your overall experience with Rim Family Services.
(Required.)
Excellent
Good
Adequate
Poor
Very Poor
Excellent
Good
Adequate
Poor
Very Poor
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11.
Rim Family Services provided me with referrals to other programs when they were unable to provide the services I needed.
(Required.)
Yes
No
N/A
If yes (please specify)
12.
Other services you wish Rim Family Services would offer their clients.
13.
Any other comments you wish to make.
