Genesis, A New Beginning - Program Evaluation
1.
Primary location of your sessions
Concord
Salisbury
Charlotte
Asheboro
2.
Primary Clinician name
3.
Please indicate how much you AGREE or DISAGREE with each statement
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You trust your clinician
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Time schedules for sessions are convenient for you
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
It's always easy to follow or understand what the clinician is trying to tell you
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
This program expects you to learn responsibility and self-discipline
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician is easy to talk to
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You are willing to talk about your feelings during sessions
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
This program is organized and well run
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You are motivated and encouraged by your clinician
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You have made progress with your presenting problem(s)
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You have learned to analyze and plan ways to solve your problems
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You have made progress toward your treatment / program goals
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You always attend the session(s) scheduled for you
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician recognizes the progress you make in treatment
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician is well organized and prepared for each session
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician is sensitive to your situation and problems
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your treatment plan has reasonable objectives / goals
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician views your problems and situations realistically
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Other clients in this program care about me and my problems
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You have stopped or greatly reduced your drug or alcohol use while in the program
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician helps you develop confidence in yourself
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You always participate actively in your sessions
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You have made progress in understanding your feelings and behaviors
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Other clients at this program are helpful to you
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You have improved your relations with other people because of this treatment
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
The staff here are efficient at doing their job
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You are similar (or like) other clients in this program
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You give honest feedback during sessions
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You can depend on your clinician's understanding
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
There is a sense of family (or community) in this program
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
This program location is convenient for you
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You are following your clinician's guidance
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You felt your clinician was prepared for groups
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician started sessions on time
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Your clinician stopped sessions on time
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
The receptionist answered and returned your calls in a timely and courteous manner
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
Material covered during sessions or groups was beneficial
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
You would recommend this program to your family or friends
Disagree strongly
Disagree
Neutral
Agree
Agree strongly
Not applicable
4.
Please provide any additional comments or feedback below:
5.
Please rate our overall performance
1 star
2 stars
3 stars
4 stars
5 stars
If a 2 star or less, please tell us why:
Current Progress,
0 of 5 answered