Professional cost-effective assessments

Client Survey

Please take a moment to complete this survey about your experience during the assessment process.

You answers will help us improve the quality of our services.

Your survey submission will be held in the strictest confidence. We'd appreciate honest answers that are as complete as possible.

Thank you,
- Assessment Services

Name:
Date of Birth:

1) Drug / Alcohol Evaluation

a. What agency provided your alcohol / drug evaluation?

b. Do you feel the evaluator treated you with respect, concern and courtesy?

c. Do you believe your evaluation accurately reflected your level of alcohol and or drug consumption and any problems you have experienced related to drug or alcohol use?

d. Were you honest in your answers to the questions on the written test you were given?

e. If you answered no to items c, d or e please explain.

2) Alcohol & Drug Information School (ADIS) Level I or Level II

a. With what agency did you attend your ADIS class?

b. Do you think the instructors were:

c. Did you think it was:

d. Were the facilities:

e. Comments:

3) Checkmate, Streetsmart, Anger Control, Batterers Intervention

a. If you attended one of the above education classes, did you think the classes were:

b. Where did you attend this program?

e. Comments:

4) Inpatient or Outpatient Alcohol or Drug Counseling

a. Did you attend inpatient or outpatient alcohol or drug counseling?

b. If you answered yes to the question above, which treatment program did you attend?

c. How often did you attend?

d. Comments regarding your treatment program:

5) Treatment by Court Respresentatives

Were you treated with courtesy, respect and concern by:
a. the Prosecutor?

b. the Court Clerks?

c. the Judge?

d. your Attorney?

e. Comments:

6) Treatment by Diversion / Probation Supervisor

a. Were you treated with courtesy, respect and concern by your Diversion / Probation Supervisor?

b. Comments:

7) Manner of Diversion / Probation Supervisor

a. Did your Diversion / Probation Supervisor act in a professional and ethical manner?

b. Comments:

8) Program Impact

a. What part of Diversion / Probation has had the most impact on you or did you find the most beneficial?

9) Additional Comments or Information

a. Please include any additional compliments, criticisms, or general comments you might have.

10) Spam Prevention Question

a. Please enter the two words you see below.

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Professional cost-effective assessments

Client Survey