Child & Youth Mental Health (CYMH) Programs Client Satisfaction Questionnaire (2026)
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  • Child & Youth Mental Health (CYMH) Programs Client Satisfaction Questionnaire

    Thanks for helping us improve our Child & Youth Mental Health (CYMH) Service by telling us about your experience. The questionnaire will take between 5-15 minutes to complete, depending on what information you include. Your responses are confidential.
  • Please let us know who is filling out this questionnaire:*
  • Review of service received:*

  • CYMH Intake Service Feedback

  • I accessed the CYMH Intake Service by:*
  • Accessing service was easy and uncomplicated*
  • I last received service*
  • The response time to my request was acceptable*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc.).*
  • My situation has improved as a result of the support and information given.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*

  • CYMH Crisis Service Feedback

  • I accessed CYMH Crisis Service by:*
  • Accessing service was easy and uncomplicated*
  • I last received service*
  • The response time to my request was acceptable*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • My situation has improved as a result of the support and information given.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*

  • CYMH Counselling Clinic Feedback

  • I last received service*
  • I was explained the service and confidentiality in a way that was easy to understand.*
  • I felt my rights as an individual were respected at all times.*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • My situation has improved as a result of the support and information given.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*
  • I have specific comments for my therapist /clinician*

  • CYMH Child & Family Therapy Feedback

  • I last received service*
  • I was explained the service and confidentiality in a way that was easy to understand.*
  • I felt my rights as an individual were respected at all times.*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • My situation has improved as a result of the support and information given.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*
  • I have specific comments for my therapist /clinician*

  • CYMH Intensive Services Feedback

  • I last received service*
  • I was explained the service and confidentiality in a way that was easy to understand.*
  • I felt my rights as an individual were respected at all times.*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • My situation has improved as a result of the support and information given.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*
  • I have specific comments for my therapist /clinician*

  • Coordinated Service Planning Feedback 

  • I last received service*
  • I was explained the service and confidentiality in a way that was easy to understand.*
  • I felt my rights as an individual were respected at all times.*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • I feel satisfied with the service I received.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*

  • Youth Justice Committee Feedback

  • I last received service*
  • Who were you referred by?*
  • I was explained the service and confidentiality in a way that was easy to understand.*
  • I felt my rights as an individual were respected at all times.*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • I feel satisfied with the service I received.*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*

  • General Feedback

  • How long ago was this service accessed?*
  • Did you feel that your rights as an individual were respected at all times*
  • I feel my identity needs were met (i.e. culture, 2SLGBTQ, physical accommodations, etc).*
  • If I need help in the future, or if a friend was in need of similar help, I would return or recommend Family Connexions CYMH service*
  • Thank you for taking the time to complete this questionnaire. Would you like someone to connect with you to discuss any of your concerns, feedback, etc.?*
  • Format: (000) 000-0000.
  • Should be Empty: