Please take a few minutes to tell us how we are doing.

Sharing your experiences with us is vital in helping us strive to provide program excellence to those we serve. Please check the appropriate box.

Question Title

* 1. Program Area:

Question Title

* 2. Date:

Today's Date:

Question Title

* 3. My rights and responsibilities were explained to me and I know how to find this information when needed.

Question Title

* 4. I feel Glade Run staff are welcoming.

Question Title

* 5. I am asked for my input about the strengths and needs of myself/my family.

Question Title

* 6. I helped to create the current goals.

Question Title

* 7. I can openly communicate without feeling judged.

Question Title

* 8. I am treated with respect.

Question Title

* 9. Glade Run staff are friendly and polite.

Question Title

* 10. Glade Run staff routinely communicate with me.

Question Title

* 11. I receive updates on progress towards goals.

Question Title

* 12. I receive information about the services available at Glade Run.

Question Title

* 13. Glade Run staff show concern for my family's improvement.

Question Title

* 14. I have a voice regarding decisions involving care, treatment and services.

Question Title

* 15. The program is helping me/my family.

Question Title

* 16. Glade Run staff promote safety for all.

Question Title

* 17. My needs are being addressed.

Question Title

* 18. I receive information on resources/events that are relevant and beneficial to me.

Question Title

* 19. Glade Run staff are helping/have helped me build a supportive network in my community (family, friends, resources, etc.).

Question Title

* 20. I feel confident the skills I have learned can be used in my home, community and/or the school.

Question Title

* 21. What is Glade Run doing well?

Question Title

* 22. What challenges did you encounter with Glade Run?

T