How Are We Doing?

HOW ARE WE DOING?

Please take a few minutes to tell us how Child Guidance Center is serving you.

Indicate which location and service you are rating:

We would like for you to give us a grade for each statement presented below. Did we do a great job? If so, please check the "A" for that statement. If we are doing an "OK" job, check the "C". If we need improvement, check the "D". If you don't want to grade a statement, check the "X".	Great Job	Pretty Good	OK	Need Improvement	No Opinion
SERVICE DELIVERY & COLLABORATION
a. The wait to be seen is reasonable	A	B	C	D	X
b. All of my questions are answered	A	B	C	D	X
c. The staff spends enough time with me and my child	A	B	C	D	X
d. The staff is friendly and helpful	A	B	C	D	X
e. I understand the words used by the staff	A	B	C	D	X
INFORMATION & UNDERSTANDING
a. My rights as a consumer have been explained to me	A	B	C	D	X
b. I have received help in understanding my child's special needs	A	B	C	D	X
c. I have received information on the services offered	A	B	C	D	X
d. Information is given to me and I am spoken to in my native language or language I understand	A	B	C	D	X
e. I am given enough information to manage my child's care	A	B	C	D	X
PROGRAM SATISFACTION
a. The waiting rooms, therapy rooms and restrooms are clean and comfortable	A	B	C	D	X
b. I am able to reach staff by telephone when I need to	A	B	C	D	X
c. I am satisfied with my child's progress at this time	A	B	C	D	X

Please feel free to make any other comments about the services you have received.

Thank you for your time and feedback.