DCCCMH Surveys

Hello, thanks for participating. Please complete the following survey.

Customer Satisfaction Survey

Staff do a good job of telling me about my rights as a consumer.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
Staff believe I can grow, change and recover.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
Staff follow through on recommendations they make: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
I can choose where I live.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
I believe the staff have my best interest in mind.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
As a result of the services I receive at DCC, I deal much better with my daily problems: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
Staff are willing to see me as agreed on in my Plan of Service.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
Staff I work with seem to know their job.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
Staff have helped me to keep a home or apartment in the community.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
My doctor tries to find the medications that work best for me.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
If I don't want the services the staff recommend, they will give me other choices.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
As a result of services I receive at DCC, I do better with my leisure time.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
My opinions and ideas are included in my treatment plan.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
I was able to get all the services talked about in person centered planning.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
My doctor and staff have told me what side effects to watch out for when taking my medication.: I Strongly Agree I Agree I am Neutral I Disagree I Strongly Disagree Not Applicable
Services Received (Optional)
Name (Optional)
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