Client Experience Survey

We are glad you reached out to us for help. How did we do? Please fill out this quick survey (15 questions) to tell us about your experience at CFS.

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* 1. How did you receive services at our agency?

By internet access or virtual conference

By phone

By text or email

Other (please specify)

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* 2. How did you hear about our services?

The agency website

Social media or other internet sources

Family or friend

Court or probation

Poster or other print material

Other mental health professional or agency

Other (please specify)

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* 3. What barriers made it harder for you to access services at our agency?

Not applicable (I had no problems accessing services)

I did not have the technology (phone, laptop, tablet) I needed to access services

I had trouble with internet access

I had trouble with the video or phone connection

I had trouble with the forms or paperwork

I am busy during the service hours

The services I needed were not available here

I did not have a private space available to me

I did not have childcare

Other (please specify)

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* 4. What issue(s) did you seek help with?

Abuse/Violence

Addiction

Relationship Issues (family, couple, parenting)

Personal Mental Health (anxiety, depression, finances, health, grief, etc.)

Issues related to the COVID-19 pandemic

General Information

Other

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* 5. What program or service were you looking for?

Counselling

Groups & Workshops

Partner Assault Program (PAR)

Nothing specific

Other

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* 6. Did our staff help you feel heard and listened to?

Yes

Not sure

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* 7. Do you feel our staff respected your:

	Yes	No	Not Sure
Age?	Age? Yes	Age? No	Age? Not Sure
Culture or ethnic background?	Culture or ethnic background? Yes	Culture or ethnic background? No	Culture or ethnic background? Not Sure
Current life circumstances?	Current life circumstances? Yes	Current life circumstances? No	Current life circumstances? Not Sure
Gender identity or sexual orientation?	Gender identity or sexual orientation? Yes	Gender identity or sexual orientation? No	Gender identity or sexual orientation? Not Sure
Mental or physical health?	Mental or physical health? Yes	Mental or physical health? No	Mental or physical health? Not Sure
Spirituality?	Spirituality? Yes	Spirituality? No	Spirituality? Not Sure
Values and beliefs?	Values and beliefs? Yes	Values and beliefs? No	Values and beliefs? Not Sure

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* 8. How long did you wait to get the service you needed?

I received services on the same day

I waited 1-3 days

I waited 4-5 days

I waited a week or more

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* 9. Where would you have gone for help if you had not been able to come to our agency?

Emergency Department

Family Doctor

Family or Friend

Other Mental Health Agency

Spiritual Leader

Walk-in Medical Clinic

Nowhere

Other (please specify)

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* 10. Did you require further resources that were not available at this agency?

Yes

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* 11. Are there areas of service that we could improve on?

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* 12. What did you like most about getting services at our agency?

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* 13. Would you recommend our services to others?

Yes

Maybe

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* 14. Overall, how satisfied are you with the services you received?

Very satisfied

Satisfied

Neither satisfied nor dissatisfied

Dissatisfied

Very dissatisfied

Client Experience Survey

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* 1. How did you receive services at our agency?

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* 2. How did you hear about our services?

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* 3. What barriers made it harder for you to access services at our agency?

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* 4. What issue(s) did you seek help with?

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* 5. What program or service were you looking for?

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* 6. Did our staff help you feel heard and listened to?

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* 7. Do you feel our staff respected your:

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* 8. How long did you wait to get the service you needed?

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* 9. Where would you have gone for help if you had not been able to come to our agency?

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* 10. Did you require further resources that were not available at this agency?

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* 11. Are there areas of service that we could improve on?

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* 12. What did you like most about getting services at our agency?

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* 13. Would you recommend our services to others?

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* 14. Overall, how satisfied are you with the services you received?

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* 15. Is there anything else you would like to share with us about your experience?