Client Experience and Satisfaction Survey

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Thank you for taking the time to provide us with valuable feedback so that we at Center for Valued Living (C4VL) can provide our clients with the best possible experience!

This survey is estimated to take about 3-5 minutes to complete.

In this survey, there are 24 multiple choice and rating items and three (3) spaces where you can provide us with additional feedback. Although all items are helpful for us to receive feedback on, please complete as much of this survey as you feel comfortable with.

Your confidentiality is important to us. Please do not provide any identifying information, unless you want us to know who you are. If you'd like us to know who you are and/or who your treating provider is, please share that information in the space where you can provide additional feedback.

If you have specific complaints that you would like to receive a response to, please access the "Client Complaints and Grievances" here: https://www.centerforvaluedliving.com/contact.html

Again, thank you for your time and feedback!

For rating questions: 1= Strongly Disagree, 2=Disagree, 3=Neutral, 4=Agree, and 5=Strongly Agree.

How many appointments have you had with your provider?

1-4 appointments

5-12 appointments

13-24 appointments

25-50 appointments

over 50 appointments

Clear selection

I primarily receive services

at a physical office location: Parker Road

at a physical office location: Smoky Hill Road

via telehealth

sometimes at the office, sometimes via telehealth

Clear selection

What insurance do you use to pay for therapy services?

Medicaid

Commercial Insurance

Private Pay

Clear selection

I like the service that I receive at C4VL.

Strongly Disagree

Strongly Agree

Clear selection

If I had other choices, I would still choose to receive services at C4VL.

Strongly Disagree

Strongly Agree

Clear selection

I would recommend C4VL to family and/or friends.

Strongly Disagree

Strongly Agree

Clear selection

The location of services is convenient and easily accessible (parking, public transportation, distance, virtual accessibility for telehealth clients, etc.).

Strongly Disagree

Strongly Agree

Clear selection

I was able to schedule my first appointment in a timely manner.

Strongly Disagree

Strongly Agree

Clear selection

The waiting room environment was comfortable and appropriate. (choose 3/neutral if you are a telehealth client)

Strongly Disagree

Strongly Agree

Clear selection

My provider’s office (physical or virtual) created a pleasant environment for sessions.

Strongly Disagree

Strongly Agree

Clear selection

I am able to navigate the Client Portal.

Strongly Disagree

Strongly Agree

Clear selection

I am able to log into teletherapy sessions easily. (choose 3/Neutral if you have only had appointments at a physical office location)

Strongly Disagree

Strongly Agree

Clear selection

My provider is able to see me regularly.

Strongly Disagree

Strongly Agree

Clear selection

I feel comfortable asking my provider questions about my treatment.

Strongly Disagree

Strongly Agree

Clear selection

I feel heard, understood, and respected by my provider.

Strongly Disagree

Strongly Agree

Clear selection

We talk about what I want to work on and talk about in sessions.

Strongly Disagree

Strongly Agree

Clear selection

I feel like my provider is a good fit for me.

Strongly Disagree

Strongly Agree

Clear selection

My provider is mindful and respectful to my identities (e.g., race, gender, sexual orientation, language, etc.).

Strongly Disagree

Strongly Agree

Clear selection

My provider shows interest in understanding and incorporating my identity into my treatment needs.

Strongly Disagree

Strongly Agree

Clear selection

I feel safe with my provider.

Strongly Disagree

Strongly Agree

Clear selection

I have had helpful conversations with the billing team. (Choose 3/neutral, if you have not had any interactions with the billing team)

Strongly Disagree

Strongly Agree

Clear selection

Administrative staff were helpful in explaining billing procedures. (Choose 3/neutral, if you have not had any interactions with the billing team)

Strongly Disagree

Strongly Agree

Clear selection

I am satisfied with the financial statements I receive.

Strongly Disagree

Strongly Agree

Clear selection

My calls/messages are returned promptly and respectfully by administrative staff.

Strongly Disagree

Strongly Agree

Clear selection

Provider and Treatment related: Do you have any specific concerns or complaints about your treatment? Are there some things you feel were especially good or helpful about your treatment?

Administrative Team and Billing Team Related: Do you have any specific concerns or complaints about your experiences with the administrative or billing teams? Are there some things you feel were especially good or helpful about your experiences with them?

Do you have any other feedback for C4VL to make your experience or the experience of future clients better?

Please share with us how you heard about this survey:

I scanned the QR code in the waiting room.

I went through the invitation in the client portal.

I went through the link in my appointment reminder.

Other:

Clear selection

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