Client Survey

We value and appreciate your comments in determining the quality of our service. Please take a moment to help us by completing the questions below. Thank You.

All fields are required.

	Strongly Agree	Agree	Neither Agree Nor Disagree	Disagree	Strongly Disagree	Not Sure/ Not Applicable
1.  The organization’s facilities are clean and well maintained.
2.  The organization respects the confidentiality of the persons it serves.
3.  The organization is known for its integrity and ethical practices.
4.  The organization promptly screens applicants and persons referred for its services.
5.  Waiting periods for services are reasonable.
6.  Fees are reasonable and fair.
7.  Personnel are qualified and competent in the performance of their jobs.
8.  When you telephoned our office your call was answered quickly.
9.  Your questions in regards to fees, insurance, etc. were answered appropriately and to your satisfaction.
10. You were greeted pleasantly by the receptionist.
11. Your need for privacy with the therapist was handled appropriately and adequately.
12. You felt comfortable with the therapist, and felt you were heard and your needs addressed.
13. You would be willing to recommend Family Foundations to someone.