Client Satisfaction Survey Form 2020

Client Satisfaction Survey

For each statement below, please check the response that comes closest to your own feelings. Please return by online submittal, via mail using the address listed below or fax to CHOH at 1(888) 633-2339.

Overall satisfaction of service

	Strongly Disagree	Disagree	Neither Agree or DIsagree	Agree	Strongly Agree
I received a thorough orientation at the beginning of services
I received information on Client Rights and Responsibilities.
I received information on Grievance/Complaint procedures.
My input was encouraged and incorporated into treatment.
CHOH Therapist and/or Paraprofessional met with my child when scheduled.
I feel listened to and accepted.
I feel respected.
My questions were answered.
My school/home situation is more stable as a result of receiving services.
Overall, I feel CHOH has helped me.
(Adults only) CHOH has helped me so that I am more stable.