Youth Emergency Services :: Satisfaction Survey

Make A Difference

Stability

Compassion

Enrichment

Unconditional Support

Kindness

	Strongly Disagree	Disagree	Neutral	Strongly Agree	N/A
1. The client was given hope and encouragement?
2. The client's medical needs were addressed?
3. Therapy was provided?
4. Y.E.S House psychiatric services were provided?
5. Client, parent, and/or other stakeholders were treated with dignity and respect?
6. Clients and family were educated on treatment and medications options?
7. Basic Shelter was provided?
8. Adequate food was provided?
9. Educational services were provided?
10. Substance abuse treatment was provided?
11. The treatment team was supportive?
12. Treatment Plans, Case Plans, or Family meetings were held regularly?
13. Staff made every attempt to keep the client safe?
14. Programs were individualized to help clients succeed?
15. Staff communicated with team members for input and decisions?
16. Any grievances/complaints were addressed in a timely manner?
17. Y.E.S. Staff contributed to client success?
18. The Y.E.S. House therapist contributed to client and families success?
19. The Y.E.S. House teachers contributed to client and families success?
20. Overall, the Y.E.S. House services were supportive and effective?

	Yes	No	If No, What would have made using our services easier or better?
Physical/architectural aspects allowed easy use of the facilities			<? if ($form_submitted != "yes") { echo $_POST['comment1'];}?>
If the client was put on a waiting list was it short			<? if ($form_submitted != "yes") { echo $_POST['comment2'];}?>
A safe environment was provided			<? if ($form_submitted != "yes") { echo $_POST['comment3'];}?>
Confidentiality was maintained			<? if ($form_submitted != "yes") { echo $_POST['comment4'];}?>
Communication was in understandable language			<? if ($form_submitted != "yes") { echo $_POST['comment5'];}?>
Input was asked for and used			<? if ($form_submitted != "yes") { echo $_POST['comment6'];}?>
Special needs were addressed			<? if ($form_submitted != "yes") { echo $_POST['comment7'];}?>
Services were provided without regard for ability to pay			<? if ($form_submitted != "yes") { echo $_POST['comment8'];}?>
Transportation was available			<? if ($form_submitted != "yes") { echo $_POST['comment9'];}?>
Services were provided to prepare/apply for employment			<? if ($form_submitted != "yes") { echo $_POST['comment10'];}?>

Client Satisfaction Survey