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* 1. Please choose your location

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* 2. Services which this feedback addresses: (choose all that apply)

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* 3. I think my child is making progress in treatment

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* 4. I have a say in my child’s treatment plan

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* 5. My child’s providers pay attention to my child’s needs

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* 6. My child’s workers communicate with me about my child

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* 7. Overall, I am satisfied with my child’s treatment at the Center

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* 8. My child is doing better as a result of services from the Center

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* 9. My child’s appointment times fit his/her schedule

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* 10. If you participated in Telehealth services, how satisfied were you?

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* 11. I would rate the overall quality of my care as

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* 12. Name of your Guidance Center treatment provider (optional)

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* 13. Your name (optional)

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* 14. Please explain your responses and/or comment on your overall experience at TGC.

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