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ANNUAL REPORT
Bayshore Counseling Services are Funded in part by:

Mental Health and Recovery Board of Erie and Ottowa Counties




UW


Your feedback is very important to us in order to improve the quality of service of our agency.

If you prefer, you may print a copy of the survey and return it in person or by U.S. Mail to:

1634 Sycamore Line
Sandusky, Ohio 44870
419.626.9156
fax 419.621.0099

For a printable survey, please click here.

Are you completing this questionnaire for yourself or for your child?
Which services have you used?Alcohol/drug Mental Health
Demographics
Your age
Gender
Marital status
Your ethnicity
1. Were agency personnel courteous? Yes No Not applicable
2. Did your first appointment occur within a reasonable time after contacting the agency? Yes No Not applicable
3. Were appointments at a convenient time for you? Yes No Not applicable
4. Were appointments canceled or rescheduled by staff on short notice? Yes No Not applicable
5. Was the counselor professional? Yes No Not applicable
6. Did you wish for your family to be involved in treatment? Yes No Not applicable
       If yes, was your family/spouse involved? Yes No Not applicable
7. Did you feel comfortable with the counselor? Yes No Not applicable
8. Did you feel comfortable that your concerns were handled confidentially? Yes No Not applicable
9. Was the counseling helpful for you and/or your family members? Yes No Not applicable
10. Were the services provided to you what you needed? Yes No Not applicable
11. Did you receive medication services from our agency psychiatrist? Yes No Not applicable
       Is your medication working? Yes No Not applicable
       Do you have any medication concerns? Yes No Not applicable
       Are you satisfied with your medication services? Yes No Not applicable
12. Are you satisfied that your service providers were culturally aware and competent? Yes No Not applicable
13. Would you recommend the agency to others? Yes No Not applicable
14. If you needed to, would you come back again? Yes No Not applicable
Suggestions for improving our services:
Please describe any barriers to your service (such as distance, transportation, appointment hours):
Were you referred by our staff to another agency or organization for additional services? Yes No
       If yes, please tell us the agency or organization name:
       Were you satisfied with the agency or organization? Yes No

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