Pathways MHS Survey

We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.

Please select from the drop down arrow.

* Indicates required field

Name of your current Provider *

Name of your previous Provider *

What is your Age? *

Your Ethnicity *

Your Sex *

If Other please specify: *

EASE OF GETTING CARE:

Ability to get in to be seen in a timely fashion *

Convenience of Clinic's location *

Hours Clinic is Open *

Office Hours *

Prompt return on calls *

Time in waiting area *

Website *

Pls. tell us how we can improve our Website *

STAFF/PROVIDER: (Therapist, Counselor, Clinical Intern)

Listens to you *

Takes enough time with you *

Explains what you want to know *

Gives good advice and resources *

What kind of improvement/s *

Office Staff - Front Desk or Admin

Friendly & helpful *

They answer your questions *

Payment: in-house and e-commerce

What you pay *

Comment *

Explanation of charges *

Collection of payment/money *

FACILITY: Our Clinic

Neat and clean building *

Easy to find *

Comfort and safety while waiting *

Privacy/Confidentiality *

TECHNOLOGY THAT WE USED

Telehealth (Audio & Video technology) *

Tele Text *

If your answer is other on Telehealth, pls. let us know *

If your answer is other on Tele Text, pls. let us know *

Do you consider this clinic your regular source of behavioral care? *

The likelihood of referring your friends and relatives to us: *

What do you like best about our clinic? *

What do you like least about our clinic? *

Suggestions for improvement *

Thank You for completing the survey!

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​Patient Satisfaction Survey

Patient Satisfaction Survey