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Satisfaction Survey

Please fill out the following form, indicating your satisfaction with the services at Challenges. If the statement does not apply to you, choose "Neutral" for that statement. When finished, click the "Submit" button.

Your Name: Phone:
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1.
 The admission staff was professional and responded quickly and competently to my needs.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
2.

The intake process was efficient and comprehensive.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
3.
 I received communication from the clinical team/ case manager in a timely manner after admission.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
4.
 The case manager and members of the clinical team maintained regular communication with me during the patient's treatment.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
5.
 Questions, concerns and suggestions which I had were addressed in a timely manner by the clinical staff.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
6.
 I received ongoing access to communicate with staff members as necessary.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
7.
 The clinical team displayed competency in their treatment.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
8.
 My input was included in the ongoing treatment planning process.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
9.
 The entire range of the patients behavioral health care illnesses were addressed together during treatment.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
10.
 My input was solicited and included in the discharge planning process.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
11.
 I received a copy of the discharge summary in a timely manner after the patient was discharged.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
12.
 The case management needs of the patient were addressed throughout the treatment process.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
13.
 The patient's family was included within the treatment process.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
14.
 My patient was treated professionally, ethically and competently.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
   
15.
 The services provided by Challenges were satisfactory.
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
                     

 
Gorski Center of Excellence Relapse Prevention Dual Diagnosis