Carol's Hope Discharge Questionnaire
Carol's Hope Discharge Questionnaire
1. The physical space of the facility and staff felt inviting and dignified.
*
Strongly Agree
Agree
Disagree
Strongly Disagree
2. I feel my voice was heard and my questions were answered.
*
Strongly Agree
Agree
Disagree
Strongly Disagree
3. Staff were supportive and believed I could recover.
*
Strongly Agree
Agree
Disagree
Strongly Disagree
4. Staff listened to me and respected my decisions about my referral options.
*
Strongly Agree
Agree
Disagree
Strongly Disagree
5. Agency staff respected my decisions about my culture, ethnicity, lifestyles and interests.
*
Strongly Agree
Agree
New Option
New Option
6. I enjoyed my overall experience in seeking treatment.
*
Strongly Agree
Agree
Disagree
Strongly Disagree
Submit
If you are human, leave this field blank.