1. Victor Satisfaction Survey

Our goal at Victor is to provide you with exceptional service. Would you please take a moment to provide us with feedback regarding the services you received?
(Please check one for each question)

* 1. Please respond to the following:

* 2. What services did you receive?

* 4. Check One:

* 5. Overall I am satisfied with the services I received from Victor.

* 6. The intake and assessment process was effective and efficient.

* 7. My questions and concerns were addressed in a timely manner.

* 8. The program involved me in treatment/service planning.

* 9. The staff was professional and helpful.

* 10. Appointments and meetings were scheduled collaboratively.

* 11. Psychiatric/medication support services were available and appropriate.

* 12. The staff was respectful of my values and culture.

* 13. If I was to seek help again, I would use your program.

* 14. How long have you received services from our agency?

* 15. What other information would you like to share with us about your services?