Client Experience Survey

Dear Client:

CMHA Waterloo Wellington is committed to providing the highest possible quality of care to our clients. In order to help us do that, we are asking you to complete this survey about your experiences here so we can continue to do what we do well and to make improvements where needed.

Your name will not appear anywhere on the survey, and your answers are completely anonymous and confidential. Results will be reported only at a program or organization level, and no one involved in your care will know how you responded.
While we hope that you will give us your feedback, whether you do the survey is entirely your decision. Saying no will not affect your care in any way. You can also skip any question you don’t want to answer and you can stop doing this survey at any time.

The survey will take about 15 minutes of your time. For each item, check the box that most accurately reflects your experience. Please answer all questions for the program or service where you currently receive support.

Thank you.

Please rate your knowledge/experience.

CMHA Form# RHP F 1015

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