GAC
Clinical Outcomes
3rd Qtr 2012
Survey Overview
Please select which service you receive. If you receive
more than ...
How long have you received services from us?
Please answer YES or NO to the following series of
questions about ...
So far are you satisfied with the services you receive at
our agency?
Did you help to choose your services?
Did you help to choose your treatment goals?
Do the people helping you stick with you no matter
what?
Do you feel you have someone to talk to when you are
troubled? Or c...
Do you participate in your own treatment?
Do you believe you are receiving services that are right
for you?
Are your services in a convenient location for you?
Are your services at a convenient time for you?
Do you feel you get the help you want?
Do you feel you as much help as you need?
Do you feel staff treats you with respect?
Do you feel staff respects your family's religious/spiritual
beliefs?
Does staff speak with you in a way you understand?
Do you believe staff are sensitive to your cultural/ethnic
background?
Do you feel hopeful about the services you receive
here?
Which of the following places have you lived in over the
past 3 mon...
In the last year, have you seen a medical professional,
like a doct...
Are you on medication for emotional/behavioral
problems?
If yes, did the doctor or nurse tell you what side effects
to watch...
In the last 3 months have you been arrested by the
police?
In the last 3 months, did you go to court for something
you did?
How often were you absent from school during the last
month?
Why did you miss school?
Do you receive any other services from us? If you
check yes you wi...
What has been the most helpful thing about the
services you received?
encouragement
talking & advise from therapist
having someone to talk to and prescription to help calm down
going on trips
positive action
i Dont Know
I don't Know
nothing
Help with homework and academic intervention
What do you feel would improve the services you
receive here?
great as is
good the way things are
my behavior
nothing
IIH service
none
Nothing
he need to focus and get yourself together
nothing
do not change anything
Why did you miss school?
run away
boring
went to the beach