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CLIENT SATISFACTION SURVEY
Your feedback helps us improve services for you and others.
Your responses are completely confidential and will not affect your care in any way.
Thank you!
1.
Please select the location for which you are filling this survey out
NBCC
BCC
NBCC Mobile Unit
BCC Mobile Unit
2.
Please select the program to which you are enrolled:
Opioid Treatment Program with MAT (Methadone/Buprenorphine/Vivitrol)
Substance Use Program
Mental Health Program
*
3.
Time in Program
(Required.)
Less than 3 months
3-6 Months
7-12 Months
1-2 years
Greater than 2 years
4.
Your Experience
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I was admitted into services in a reasonable amount of time
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
Program rules and expectations were clearly explained to me
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
Staff treat me with respect
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I feel heard and listened to by staff
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I feel safe when receiving services
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
Staff understand my needs
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I am involved in my treatment planning
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
My treatment plan meets my needs
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
The facility environment feels welcoming and professional
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
5.
Access and Communication
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
It is easy to contact staff when I need help
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I am able to get referrals or resources when needed
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
Telehealth services are easy to use
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
The location is accessible for my needs
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
6.
Treatment Outcomes
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
My quality of life has improved since starting services
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I am better able to manage my mental health and/or substance use
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
I am doing better in daily activities (work, school, etc.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
My relationships or support system have improved
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
N/A
7.
Overall, how satisfied are you with the services you have receieved?
Very satisfied
Satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Dissatisfied
Very dissatisfied
8.
Would you recommend our services to others?
Yes
No
Maybe
9.
What has been the most helpful thing about the services you received?
10.
What would improve the services here?
11.
Is there anything else you would like to share?
12.
Please rate the overall quality of the services provided
1 star
2 stars
3 stars
4 stars
5 stars