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Consumer/Family Feedback Survey
Please help us to identify the strengths of our network along with areas where we have room to grow.
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* Indicates required question
Which county are you in?
*
Coshocton
Guernsey
Morgan
Muskingum
Noble
Perry
Which agency/agencies are you working with?
*
Allwell Behavioral Health Services
Coshocton Behavioral Health Choices
Guernsey Health Choices
Morgan Behavioral Health Choices
Muskingum Behavioral Health
Noble Behavioral Health Choices
Perry Behavioral Health Choices
Required
Which services are you currently receiving?
*
Outpatient counseling
Case Management
Medication services
groups
family counseling
Other:
Required
Have you or your family member been able to get services near your home and in a reasonable length of time?
*
Yes
No
Other:
Are you or your family member involved in treatment planning?
*
Yes
No
I don't know
How has your life been improved as a result of the services you have received?
*
Your answer
What services have been most important to your recovery and why?
*
Your answer
Are there services that would help your recovery that are currently not available?
Yes
No
Clear selection
If so, what suggestions do you have?
Your answer
Anything else you would like us to know?
Your answer
Name and contact information (OPTIONAL)
Your answer
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