Mental Health & Recovery Board Outcomes & Satisfaction Survey

In order to provide the best possible services, we need to know what you think about the services you or your family received from the identified agency during the last THREE MONTHS.  

Please only answer once for each question unless otherwise indicated.  Thank You!

How connected are you with family, friends and the community?*



Have the services you, or your family, received at this agency helped you do the things you want to do?*





How satisfied are you with the services you or your family received from this agency?*





How easy was it to get the services you or your family needed from this agency?*





Were the agency staff sensitive to you or your families cultural/ethnic and religious/spiritual preferences?*





Were you or your family involved in deciding which services were needed to address the concerns you had?*





Have the services you or your family received at this agency helped you address the concerns that brought you in?*





Which Agency(ies) are you or your family receiving services from?*





Age of Person Receiving Services
Gender


Race





Length of Time Receiving Services at Agency





Highest Grade Level Achieved






Email (Optional):
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