Helpline Caller Mental Health SURVEY
What is your level of satisfaction of your call today?
Very Satisfied
Satisfied
Not Satisfied
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How likely would you call again?
Highly Likely
Likely
Not Likely
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Would you refer someone else to contact us?
Yes
No
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Did you find the information received from the counselor helpful?
Yes
No
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Would you like us to follow up with you?
Yes
No
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Full Name
Your answer
Phone Number
Your answer
Email Address
Your answer
Please describe yourself
Adult / Parent / Guardian
Student
City of Houston Personnel
HISD Personnel
Other:
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Primary language
English
Spanish
Other:
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Your Zip Code
Your answer
Name of School (if applicable)
Your answer
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