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Provive Alumni 30Day Follow Up Survey
1.
Who is filling out this survey?
2.
How would you rate your overall progress since completing treatment?
1 star
2 stars
3 stars
4 stars
5 stars
6 stars
7 stars
8 stars
9 stars
10 stars
3.
How would you rate your quality of life currently?
1 star
2 stars
3 stars
4 stars
5 stars
4.
How would you rate your quality of life prior to coming to Provive Wellness?
1 star
2 stars
3 stars
4 stars
5 stars
5.
How would you rate your self worth currently?
1 star
2 stars
3 stars
4 stars
5 stars
6.
How would you rate your self worth prior to coming to Provive Wellness?
1 star
2 stars
3 stars
4 stars
5 stars
7.
How would you rate your mental health currently?
1 star
2 stars
3 stars
4 stars
5 stars
8.
How would you rate your mental health prior to coming to Provive Wellness?
1 star
2 stars
3 stars
4 stars
5 stars
9.
Have you experienced any mental health crisis or returned to substance use since leaving treatment?
Yes
No
10.
If you answered yes to the last question & would like the Alumni team to reach out to support please let us know a good contact number.
11.
Are you attending any support groups? (12 step, Dharma, Double Trouble, etc.) Select all that apply
Yes, regularly
Yes, occasionally
No, but I plan to
No
12.
On average, how many support group meetings do you attend per week?
None
1-2
3-4
5 or more
13.
Do you have a sponsor or certified peer support?
Yes
No
14.
Are you working currently?
Yes
No
15.
Were you working prior to coming to Provive Wellness?
Yes
No
16.
How long were you in treatment with Provive Wellness?
Less than 1 month
1-3 months
3-6 months
More than 6 months
17.
Did you complete the program at Provive Wellness?
Yes
No
18.
Have you received treatment after your time at Provive Wellness?
Yes
No
19.
Are there any staff you would like to give a shoutout or special recognition?
20.
Would you like to stay connected with our Alumni Program?”
Yes
Maybe, Tell Me More
No
21.
If you're interested in more Alumni information or you would like a team member to reach out please let us know a good contact phone number or email