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BEHAVIORAL HEALTH CLINIC SURVEY
1.
How many stars would you use to rate this clinic where "one" star is the worst possible experience and "ten" stars is the best possible experience?
Worst possible
1 star
2 stars
3 stars
4 stars
5 stars
6 stars
7 stars
8 stars
9 stars
Best possible
10 stars
2.
Please rate the
Office and Support Staff
at Behavioral Health with the answer that best describes your experience. If a question does not apply to you, please choose Not Applicable.
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Friendly
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Professional
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Respectful
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Knowledgeable
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Timely
Always
Usually
Sometimes
Rarely
Never
Not Applicable
3.
Please rate the
Clinical Provider
at Behavioral Health with the answer that best describes your experience. If a question does not apply to you, please choose Not Applicable.
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Friendly
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Professional
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Respectful
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Knowledgeable
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Timely
Always
Usually
Sometimes
Rarely
Never
Not Applicable
4.
Please rate the Behavioral Health
Facility
. Choose the answer that best describes your experience. If a question does not apply to you, please choose Not Applicable.
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Cleanliness
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Privacy
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Comfort
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Appearance
Always
Usually
Sometimes
Rarely
Never
Not Applicable
Safety
Always
Usually
Sometimes
Rarely
Never
Not Applicable
5.
What has been positive about your time spent in our department?
6.
How can we make your experience better in the future?
