Discharge Survey 1. Question Title * 1. Program/Region Jacksonville Wilmington Elizabeth City Wilson Greenville Kinston Smithfield Raleigh Rocky Mount Fayetteville Goldsboro Question Title * 2. Are you? Adult Consumer Child/Adolescent Consumer Parent Family Member Question Title * 3. What Pride In North Carolina Services did you ( or your family member) receive? In Home Therapy Services (IHTS) School Based Therapy Office Based Outpatient Therapy Intensive In Home services (IIH) Community Support Team (CST) Medication Management-Psychiatric services Psychosocial Rehabilitation (PSR) High Fidelity Wraparound Other (please specify) Question Title * 4. Overall I was satisfied with the quality of services provided by Pride In North Carolina, LLC. (Required.) Yes No Unknown Question Title * 5. Overall I feel my/ my child/family member's quality of life has improved or changed for the better since receiving services and supports from Pride In North Carolina, LLC. Yes No Not sure at this time Question Title * 6. I/My family member is/am better able to handle problems since reciveing services from Pride In North Carolina, LLC. (Required.) Yes No Unknown Other (please specify) Question Title * 7. I/my family member am/is better able to function at home/school/ work since receiving services from Pride In North Carolina, LLC. (Required.) Yes No Unknown Other (please specify) Question Title * 8. Pride In North Carolina, LLC. staff treated me with respect and honored any culturally needs or preferences I requested. (Required.) Yes No Unknown Other (please specify) Question Title * 9. What specifically were some of the cultural needs/preferences you requested or expressed while in treatment? Materials/handouts in other languages Time off of services/sessions during a specific holiday/time of year Preference for staff of a certain gender or race Needs related to medication (taking or not taking medications) Addition of faith based supports/people included on Treatment teams Addition of cultural needs/preferences on the PCP or crisis plan Question Title * 10. My (or my family member's) discharge from Pride In North Carolina, LLC. was planned and appropriate. (Required.) Yes No Unknown Other (please specify) Question Title * 11. Was your discharge due to: Dissatisfaction with service provided My hours/services got cut by Value Options/MCO/Insurance agency Progress was made and no longer needed support I (family member) did not follow treatment recommendations I went to another Provider Agency (same service) Other (please specify) Question Title * 12. Following my (or my family member's) discharge my overall wellbeing has: Continued to Improve Remained the same Gotten Worse Question Title * 13. I/my family member am/is in need of further services or supports? Yes No Question Title * 14. I would like for someone to contact me: Done