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  • CLIENT SURVEY
  • NEW HIRE FORMS
  • Home
  • About
  • Appointments & Forms
    • New Client Intake Form
    • Returning Client Form
    • Release of Information Form
    • Health Screeners
  • Services & Staff
  • Employment
    • Case Managers
    • Bilingual Case Mgrs
    • Clinical Therapist
  • Contact Us
  • Staff Resources
    • CBHC Forms
    • Resources
    • Staff Meeting Updates
  • CLIENT SURVEY
  • NEW HIRE FORMS

CLIENT SATISFACTION SURVEY

    Your experience with CBHC is important to us. Your answers
    will be kept anonymous and confidential and will only be used for internal
    use to help us improve our services. Thank you!


    General


    Improvment


    Safety


    Courtesy


    How would you rate the courtesy of the following staff? 


    Overall ratings


    What is your overall opinion of:


    Please tell us: 



    Optional:


    If you would like to be contacted by a representative to discuss any aspect of your treatment, please include your name and a daytime phone number.


    Thank you for taking the time to help us learn how we can improve our services!

Submit
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