Satisfaction Survey
Name
First Name
Last Name
Which provider is treating you at Psychiatric Wellness?
*
Elisabeth Mustachia, PMHNP-BC
Jeannie TallBear, PMHNP-BC
Ronda Armendariz, LPC
Allison Jackson, PMHNP-BC
Jennifer Davis, PMHNP-BC
Sarah Senger, PMHNP-BC
Jordan Permaul, PMHNP-BC
Jeri Essary, PMHNP-BC
Jason White, PMHNP-BC
Melissa Kenny, PMHNP-BC
Kendra Stormo, PMHNP-BC
Anu Marrott-Ware, PMHNP-BC
Carley LeMoine, PMHNP-BC
1. I was given my rights and responsibilities as a client.
*
Yes
No
2. If I was discharged, I was discharged because...
*
I had completed services
I was dissatisfied with services
I moved
Other
I have not been discharged, I am a current patient
3. I would refer a friend or family member to this agency.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
4. I was informed of my choices and helped to plan treatment goals.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
5. I was able to begin services promptly.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
6. If I needed help again I would come back to Psychiatric Wellness or my provider.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
7. I met with my provider regularly and have no concerns about scheduling.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
8. My provider informed me promptly if schedule changes were needed and they were on time for scheduled appointments.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
9. Overall, I am happy with my provider and the mental health services that I received.
*
1 (strongly disagree)
2
3
4
5 (strongly agree)
Other
Please provide any comments/feedback for the care that you received.
Do we have your permission to post your review publicly on our website?
*
Please Select
Yes
No
*your name will NOT be attached to the review*
Would you like to discuss your survey results with Psychiatric Wellness management?
Yes
No
Submit
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