Community Based Services (Referring Agent)
Consumer Satisfaction Survey
Frequency of communication with assigned counselor?
1-2x per week
3-5x per week
1-2x per month
How satisfied are you with the services being provided?
Please explain any dissatisfaction with the service being provided.
How satisfied are you with the communication and quality of services provided by the supervisor?
Please explain any dissatisfaction.
How likely are you to recommend/refer clients and others to Inner Circle?
Please add any other comments or suggestions that you would like to share regarding your counselor, the agency, and/or services being provided.
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