How are WE doing? 

Please feel free to provide authentic feedback regarding the organization, a practitioner, a staff member, an outreach event, the telehealth platform, or any other area you want to address on the form below. We highly value feedback and opportunities to better tailor to individual needs. 

Will this be anonymous?

Should you provide feedback regarding a service experience, please note that any feedback provided will remain anonymous to any practitioner and/or staff member it may be regarding. 

How will my feedback and comments be used? 

Feedback will be used to inform the operational managers of areas of strengths and/or areas for growth. While this information may be used to enhance overarching services, it will not be used to restrict, prohibit, or negatively alter an individual’s experience or access to services.

General Information

Name (optional)

Which services did you receive? Medication management, therapy, or both?Select oneMedication ManagementTherapyBoth

Ratings

Please rate the following on a scale of 1 through 5 (1 - Strongly Dissatisfied, 2 - Somewhat Dissatisfied, 3 - Neutral, 4 - Somewhat Satisfied, 5- Strongly Satisfied, or if N/A)

How would you rate ease accessing your scheduled appointments?

Ability to contact the office via phone and have questions addressed?

Ability to message your clinician if needed

Punctuality of clinician

Feel comfortable working with the clinician

Concerns are being met or addressed in treatment

Clinician is professional

My appointments are conducted with audio AND video through SPSelect Yes or NoYesNo

I would recommend MST to othersSelect Yes or NoYesNo

I would be interested in a potential follow-up phone call regarding my answers or responsesSelect Yes or NoYesNo

Any other general feedback that could improve your care specifically? If yes, please elaborate.

Any other comments about your care, staff, or operations?

Submit