FCIU Client Satisfaction Survey

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

Thank you for taking the time to complete this survey. Your participation helps us to better serve you. Please be assured that your responses are anonymous.
Who initiated plans to proceed with terminating FCIU services?
 *
Who initiated plans to proceed with terminating FCIU services?
Please indicate the severity of your family issues at the start of your treatment on a scale of 1 to 5 (1=minimal, 5=maximum)
 *
Please indicate the severity of your family issues at the conclusionof your treatment on a scale of 1 to 5 (1=minimal, 5=maximum)
 *
Your status at closing (check all that apply)
Your status at closing (check all that apply)
Your satisfaction with the plan at the conclusion of your treatment
 *
Your satisfaction with the plan at the conclusion of your treatment
Your satisfaction with the quality of treatment at the FCIU
 *
Your satisfaction with the quality of treatment at the FCIU
The likelihood that, if necessary, you would seek assistance from the FCIU in the future
 *
The likelihood that, if necessary, you would seek assistance from the FCIU in the future
Please feel free to comment further on any aspect of your involvement with the FCIU
  1. To receive a copy of your submission, please fill out your email address below and submit.