1. Western Psychological and Counseling, PC

Chemical Dependency Treatment Program

Your comments are valuable to us. Please take a few moments to read and complete this client satisfaction questionnaire. Your remarks will remain confidential and will assist Western in improving the services we provide.

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* Name: (Optional)

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* Please indicate the program site (Required):

  Beaverton Gladstone Vancouver

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* Please indicate your Referral Source

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* Please indicate your opinion of the following subjects:

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Admission Process
Evaluation Process
Treatment Planning
Group Sessions
Individual Sessions
Family Sessions
Office Staff
Billing Office Staff
Facility (Lobby, Group rooms, etc.)
Value of Program Curriculum
Communication with referral source
How well were you prepared for Discharge

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* Please indicate your opinion regarding your Counselor

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