Please Send Us Your Feedback!

NAMI:CV Feedback Survey

Please help us evaluate our overall services. We will use your responses to improve our work on behalf of all those affected by mental illnesses in Clinton, Franklin, and Essex Counties. Please answer the questions that apply to your experiences at NAMI:CV. You may not be able to answer every question, and that’s okay. Your responses are kept confidential and will not be disclosed to any outside agency unless required by law.

First Name

Last Name

Phone

Email Address

* What statement below best describes your situation at NAMI:CV

* How long have you been using our Support and/or Advocacy services?

* Please rate the following aspects of our service.

	Very Good	Good	Neutral	Poor	Very Poor	NA
The support group(s) that I attend promote(s) recovery, by providing me with a sense of belonging, supportive relationships, valued roles, and community.
The educational program(s) that I attend provided me with holistic information that helped me better understand and manage my mental illness and my life.
The peer advocacy services that I utilize(d) were empowering, individualized, and person-centered.
The staff and volunteers are friendly.
The staff and volunteers are respectful.
The staff and volunteers are responsive.
The staff and volunteers are empathetic.
I feel safe at NAMI:CV; I know that my confidentiality is taken seriously.
I believe that NAMI:CV promotes consumer recovery.
I feel hopeful when I come to NAMI:CV.

What do you like the most about the service(s) we provided?

What service(s) do you feel we could have improved?

* Compared to other mental health service providers, how would you rate our service(s)?

* Overall, how satisfied are you with our service(s)?

* How likely are you to continue to use our services?

* Would you recommend our service(s) to others?

Yes

No

Neutral

Use the space below to send us any additional feedback, comments, suggestions, etc.

* Indicates Response Required