2021-2022 CLIENT SURVEY

2021-2022 CLIENT SURVEY

Your experience with CBHC is important to us.

Your answers will be kept confidential and only used internally to help improve our services.
Which services are you receiving?*

Psychiatry/Medication ManagementTherapy/CounselingCase Management

SCHEDULING & ACCESS*

	Strongly Disagree	Disagree	Neither Agree or Disagree	Agree	Strongly Agree
I am able to get an appointment when I need it.
I am satisfied with the CBHC appointment reminder system.
It was easy to access services via telehealth and/or by phone.

TREATMENT*

	Strongly Disagree	Disagree	Neither Agree or Disagree	Agree	Strongly Agree
It is easy to discuss my mental health with CBHC providers who really listen to me.
There is good communication among all CBHC staff regarding my treatment.
I understand my treatment goals.
I understand the role of medication in my treatment (if applicable).
I am confident that I am receiving the correct treatment for my condition.
The condition for which I am being treated has improved.

SATISFACTION*

	Strongly Disagree	Disagree	Neither Agree or Disagree	Agree	Strongly Agree
Overall, I am satisfied with my treatment.
I would recommend CBHC to a friend or family member.

How can we improve your experience with us?
Optional: If you would like to be contacted by a representative to discuss our services, please enter your name and a daytime phone number below.
First NameLast Name
Phone Number
Thank you for taking the time to help us learn how we can improve our services!
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