Please Tell Us What You Think Please help us evaluate our services by answering the following questions about your experience with us today. All answers are anonymous. Question Title * 1. Which category best represents you? Client Parole/Probation Dept. Social Security Administration Law Enforcement Job & Family Services Hospital/ER ADAMH Board Rep. Physician's Office School System Other (please indicate organization) Question Title * 2. Who did you meet with today? Question Title * 3. Were you treated with respect and courtesy by: (Please check all that apply) Yes No Reception Staff Reception Staff Yes Reception Staff No Center Staff (With whom you had the appointment) Center Staff (With whom you had the appointment) Yes Center Staff (With whom you had the appointment) No Other Other Yes Other No Please describe any problems you encountered with anyone today: Question Title * 4. Did you meet with Center Staff at your agreed upon appointment time? Yes No Question Title * 5. Did you feel that the center representative listened to you and was attentive to your needs? Yes No If "No" was selected, please explain: Question Title * 6. Did you feel that your concerns were addressed and adequately resolved? Yes No If "No" was selected, please explain: Question Title * 7. Did Center Staff present in a professional manner? Yes No If "No" was selected, please explain: Question Title * 8. Did you find the facility and grounds to be clean, attractive and well-maintaned? Yes No If not, please let us know what you found to be unacceptable: Question Title * 9. How would you improve the experience you had today with SPVMHC? Question Title * 10. What did you like most about the experience you had today with SPVMHC? Question Title * 11. What did you like least about the experience you had today with SPVMHC? Thank you for helping us to improve what we do! Done
