Consumer Satisfaction Survey

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Which program are you providing feedback on?(Required)

Who are you providing feedback on?(Required)

Please rate the following:(Required)

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
My provider treats me with courtesy and respect.
My provider cares about my treatment goals.
I trust my provider.
The services I receive from my provider are helpful.
My provider listens carefully to my concerns & questions.
My goals and my provider’s goals are in line.
I am seeing progress made towards my goals.
I feel safe and secure when I attend my appointments.
The waiting room was clean and comfortable.
The front desk staff are friendly and courteous.
Scheduling appointments is easy.
Rescheduling appointments is easy.
I would recommend Haven House to a friend or family member.
My telehealth appointment was easy to access.

What do you like about Haven House?

Where can we improve?