Feedback

We constantly strive to improve our services to meet the needs of our clients. Your feedback is an important part of that process. Please take a few minutes to let us know about your experience at Woodland Centers, Inc.; what we've done right, and what we can do to serve you better.

Name (First, Last):
County:
Email Address:
Telephone (include Area Code):

Please tell us about your experience at Woodland Centers, Inc.

Location Visited:

Please respond to the following questions:

		Yes	No	Undecided
1.	Do you feel this service is available and accessible when you need it?
2.	Do you feel staff providing this service have been responsive to your questions and concerns?
3.	Have you received information that has helped you and your family understand and cope with your problems?
4.	Do you feel staff of this service have conducted themselves in a professional manner?
5.	Do you feel you have a clear understanding of your client rights?
6.	Do you feel your client rights have been respected?
7.	Have the agency and/or staff been respectful of your cultural and ethnic background?
8.	Do you feel you have been encouraged to be an active partner in planning your treatment goals?
9.	Do you feel this service has helped you meet your treatment goals?
10.	Do you have a clear understanding of fees and of the billing process for this service?
11.	Would you recommend this service to a friend or relative when they need it?
12.	What would you recommend to improve our facility and services?
13.	Is there a staff person(s) you feel deserves special recognition? If Yes, please include that person(s)' name in the Comments field below.
14.	Do you know how to access Crisis line/Services if needed?

How long did you use the services of Woodland Centers, Inc.?

Please enter any additional comments or your questions below: