Agency Satisfaction Survey

Please mark your choice from the answers below for each question:

Question Title

* 1. I am able to contact/reach a staff member when needed.

Question Title

* 2. I feel I have made progress/improved my life by following my treatment plan.

Question Title

* 3. I feel that staff members perform their jobs professionally.

Question Title

* 4. The complaints/grievances process has been explained to me, and I know how to contact the Client Rights Advocate.

Question Title

* 5. CSS staff believe in recovery and encourage me to learn, grow and change - helping me to move toward recovery.

Question Title

* 6. I am able to get to and from the agency easily.

Question Title

* 7. How old are you?

Question Title

* 8. Are you of Spanish, Hispanic or Latino origin or descent?

Question Title

* 9. Please indicate your gender:

Question Title

* 10. Race: Please mark one or all that you consider yourself to be:

Question Title

* 11. What is your sexual orientation?

Question Title

* 12. Is there anything you would change about CSS to make it better?

T