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TIC Survey for Consumers 2024- web access thru june

Options Client Survey 2024

Consumer Feedback Survey

We appreciate your feedback about how we are doing.

1. If you are not a client of Options, please tell us your relationship to the client:

2. Please consider your overall experience and place a mark in the box that best applies.

Space Cell	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Does not Apply
I feel safe at Options.	I feel safe at Options. : Strongly Agree	I feel safe at Options. : Agree	I feel safe at Options. : Neutral	I feel safe at Options. : Disagree	I feel safe at Options. : Strongly Disagree	I feel safe at Options. : Does not Apply
I feel comfortable sharing my feedback with Options.	I feel comfortable sharing my feedback with Options. : Strongly Agree	I feel comfortable sharing my feedback with Options. : Agree	I feel comfortable sharing my feedback with Options. : Neutral	I feel comfortable sharing my feedback with Options. : Disagree	I feel comfortable sharing my feedback with Options. : Strongly Disagree	I feel comfortable sharing my feedback with Options. : Does not Apply
I am comfortable sharing stressful life experiences with my provider.	I am comfortable sharing stressful life experiences with my provider. : Strongly Agree	I am comfortable sharing stressful life experiences with my provider. : Agree	I am comfortable sharing stressful life experiences with my provider. : Neutral	I am comfortable sharing stressful life experiences with my provider. : Disagree	I am comfortable sharing stressful life experiences with my provider. : Strongly Disagree	I am comfortable sharing stressful life experiences with my provider. : Does not Apply
I trust my provider.	I trust my provider. : Strongly Agree	I trust my provider. : Agree	I trust my provider. : Neutral	I trust my provider. : Disagree	I trust my provider. : Strongly Disagree	I trust my provider. : Does not Apply
My team works well together.	My team works well together. : Strongly Agree	My team works well together. : Agree	My team works well together. : Neutral	My team works well together. : Disagree	My team works well together. : Strongly Disagree	My team works well together. : Does not Apply
I feel included in decision-making about my plan and services.	I feel included in decision-making about my plan and services. : Strongly Agree	I feel included in decision-making about my plan and services. : Agree	I feel included in decision-making about my plan and services. : Neutral	I feel included in decision-making about my plan and services. : Disagree	I feel included in decision-making about my plan and services. : Strongly Disagree	I feel included in decision-making about my plan and services. : Does not Apply
My provider focuses on my strengths.	My provider focuses on my strengths.: Strongly Agree	My provider focuses on my strengths.: Agree	My provider focuses on my strengths.: Neutral	My provider focuses on my strengths.: Disagree	My provider focuses on my strengths.: Strongly Disagree	My provider focuses on my strengths.: Does not Apply
My provider respects what makes me unique.	My provider respects what makes me unique. : Strongly Agree	My provider respects what makes me unique. : Agree	My provider respects what makes me unique. : Neutral	My provider respects what makes me unique. : Disagree	My provider respects what makes me unique. : Strongly Disagree	My provider respects what makes me unique. : Does not Apply
I have been able to use the video sessions successfully	I have been able to use the video sessions successfully: Strongly Agree	I have been able to use the video sessions successfully: Agree	I have been able to use the video sessions successfully: Neutral	I have been able to use the video sessions successfully: Disagree	I have been able to use the video sessions successfully: Strongly Disagree	I have been able to use the video sessions successfully: Does not Apply
The video/telephone sessions have been as effective as the in-person sessions	The video/telephone sessions have been as effective as the in-person sessions: Strongly Agree	The video/telephone sessions have been as effective as the in-person sessions: Agree	The video/telephone sessions have been as effective as the in-person sessions: Neutral	The video/telephone sessions have been as effective as the in-person sessions: Disagree	The video/telephone sessions have been as effective as the in-person sessions: Strongly Disagree	The video/telephone sessions have been as effective as the in-person sessions: Does not Apply

3. Options location where I receive services: *This question is required.

4. Services I receive at Options: *This question is required.

5. Comments:

6. I would like to be contacted regarding this survey:

7. Contact Information ( Optional )

Space Cell	Name	Phone
	: Name	: Phone