Inter-Care Client Follow-up Interview
As part of the Alumni Program at Inter-Care, we have developed a client follow-up survey that enables us to maintain contact periodically throughout the year. In doing so we hope to stay informed as to how our clients are doing as they continue their journey of sustained recovery.

Please take a few minutes to fill out our fully confidential survey. Your answers will give us insight into how you have been doing since leaving Inter-Care and allow us to provide you with additional support if needed.

If you have any questions, please feel free to contact us at

Thank you for your participation.
Email Address *
To ensure privacy and the protection of your private information, please be sure to provide your email and not your name as identifiable material
Your answer
How would you rate your progress in recovery so far?
Very Poorly
Very Well
Primary Counselor(s)
How would you describe your recovery so far?
Your answer
Are you currently involved in Inter-Care's Maintenance Program?
Maintenance Program is also referred to as Phase 3 of recovery.
Are you staying clean / sober? *
If you are struggling in your recovery, are there services we can provide to assist you?
If yes, please specify how we can help.
Your answer
Please check any of the following that you are involved in
Please check any of the following you participate in
The next few questions refer to the Inter-Care Alumni program which is open to former clients as well as those in Phase 3.
Which of the following Alumni Events are you interested in?
What time of day works best for you to attend events?
May we continue to use this email to contact you about these events? *
If No, please email us at with your preferred contact information
Are you interested in receiving an E-Newsletter?
This newsletter would keep you updated on local events, acitivities and programs.
The next few questions refer to the Inter-Care Foundation, founded to create treatment opportunities for those who could not otherwise afford it. It is through the generosity of our donors that we are able to offer treatment scholarships, wellness groups and family programs to the Inter-Care community.
Are you interested in helping us to make ICF a long-lasting success?
If yes, please list below how you would like to support us?
Multiple options may be selected
Do you have any family members or friends who would be willing to support the ICF and whom we may contact?
If Yes, please provide their contact information below
Name, Address, Phone number and/or Email
Your answer
Are you interested in recieving any further information about ICF events and news in the future? *
Thank you for taking the time to fill out this survey. If your contact information has changed (phone, email, address), please email us at with the updated information.
Are you okay with us contacting you for another follow up?
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