Mental Health Services Patient Survey Thank you for completing our survey. Your feedback is anonymous unless otherwise specified and will help us make improvements so we can better serve you. 1. Which clinic did you visit?*Beach Area Family Health CenterChase Avenue Family Health CenterChula Vista Family Counseling CenterChula Vista Family Health CenterCity Heights Family Health CenterDiamond Neighborhoods Family Health CenterDowntown Family Health Center at ConnectionsEl Cajon Family Health CenterElm Street Family Health CenterFamilyHealth at City CollegeFamilyHealth-Youth Counseling CenterGrossmont Family Counseling CenterGrossmont Spring Valley Family Health CenterHealthy Development Services - CentralHealthy Development Services at Spring ValleyHillcrest Family Health CenterHillcrest Family Health Center on Third AvenueIbarra Family Health CenterLemon Grove Family Health CenterLogan Heights Family Counseling CenterLogan Heights Family Health CenterMobile Counseling CenterNational City Family Health CenterNorth Park Behavioral Health CenterNorth Park Family Health CenterOak Park Family Health CenterRice Family Health CenterSpring Valley Family Counseling Center2. Which service did you access?*OtherAdolescent PsychiatryAdult PsychiatryArchstone ProjectBehavioral HealthChild PsychiatryClinic, School, or Home-Based ServicesConcentrated Mental HealthImpact ProjectIndividual, Couple, or Family CounselingMaternal Services ProgramMental HealthPsychiatry / Medication ManagementPsychological Testing for AdultsPsychological Testing for ChildrenSubstance Use Disorder ServicesTherapy3. Who did you see?*I don't rememberLeah Aguirre, LCSWLauri Combs, LCSWEdward Erbe, MDSandra Lim, DOKelly McHenry, LCSWLupita Ortega, MFTNot listed3. Who did you see?*I don't rememberNaseem Reghabi, PsyDKathy Rozell, LCSWKris Webster, LCSWNot listed3. Who did you see?*I don't rememberEden Brown, LCSWJesse Castaneda, MADane Crockford, PsyDMarylupe Flores, LCSWTomonori Fukui, MDKassandra Korneman, MAVivian Munoz, LCSWEduardo SaldivarNot listed3. Who did you see?*I don't rememberRadomir Avila, LCSWMarylupe Flores, LCSWNot listed3. Who did you see?*I don't rememberAdrianna Alvarado, MASomora Davidson, MAChristina Forzani, PsyDTeri Hedman, LCSWRussell Lim, MDIsabell RomoAsh Tahbaz, MFTNot listed3. Who did you see?*I don't rememberSteven Arias, PhDJennifer Asuncion, LCSWMariana Badra, LCSWElizabeth Oliver, LCSWDavid OrtizYuliya Proosaselts, MDJoe Sasson, LCSWShabina Skiles, LCSWGilberto Zayas, MDNot listed3. Who did you see?*I don't rememberRodrigo Franco, LCSWRuth Gillis, LMFTSandra Lim, DOColette Lord, PhDKelly McHenry, LCSWNorma Quiroz, LMFTClaudia ValenciaNot listed3. Who did you see?*I don't rememberJerry Benzl, MDAnthony Bui, MDKrystal Carrillo, LCSWAshraf Fanous, MDJessica Fuentes, MAJoseph Hall, MDAdele Jones, PhDNairi Krekor, MADenise KiddAndres Mendez, PhDAlbert Modad, PsyDReghabi Naseem, PsyDKelly O'Bryan, PhDMargarita Oropeza, MAMelissa Sachs, LCSWJosh Tartaglione, DOJhosmara Weaver, LCSWNot listed3. Who did you see?*I don't rememberSandra D'Alonso, LCSWKelsy Kloberdanz, NPColette Lord, PhDNorma Quiroz, LMFTNot listed3. Who did you see?*I don't rememberRachel Bennet, LCSWTeresita Castellanos, LCSWRodrigo Franco, LCSWRuth Gillis, LMFTApril Johnson, PsyDNorma Quiroz, LMFTNot listed3. Who did you see?*I don't rememberJennifer Aguilar, MFTWendy Aguirre, LCSWVivian Ash, LCSWDiane Breske, ASWEmily Brown, ASWAnthony Bui, MDAlonso Cardenas, MDKrystal Carrillo, LCSWKarina Dominguez, MAJuliana Gonzales, LCSWCoral Harriman, PhDLizbeth Jimenez, MAMark Knight, MDLindsay MacMaster, PsyDSarah Marie Merrill, LCSWCeleste Martinez De LunaSarah Porras, ASWPaullette Rosette, AMFTMelissa SantosJason Schweitzer, MDCynthia SilvestreGarrick Tong, MDLaura Torres, LCSWNot listed3. Who did you see?*I don't rememberJoyce BaysaRuth Cain, LMFTJonathan Deam, MDRob LindbloomRobert Nwanganga, LCSWMelissa Sachs, LCSWErlynn Joyce Sabal, MAVictoria Valeriano, MANot listed3. Who did you see?*I don't rememberLynda Ariella, PhDDavid Dobos, MDAndres Mendez, PhDNaseem Reghabi, PsyDKathy Rozell, LCSWKris Webster, LCSWAngelica Zatarain, MANot listed3. Who did you see?*I don't rememberSofia FloresKenia Guzman, MFTKellsie Michael, LCSWNot listed3. Who did you see?*I don't rememberAlonso Cardenas, MDTiffany Cox, AMFTYo Ishida, LCSWCeleste Martinez De LunaPaola Meraz-SalasJessica MurilloLoraine Ortega, QMHPBlanca ReyesLeticia Rica, AMFTSarah Rigali, AMFTMisha RuestaGarrick Tong, MDNot listed3. Who did you see?*I don't rememberAlan Bond, PsyDDiana E. Borrego, NPMyra S. Buby, LCSWRuth A. Cain, MFTSandra L. D'Alonzo, LCSWEdward J. Erbe, MDKay M. Freeman, MFTSheila A. Gleason, PhDHelen A. Hayden-Wade, PhDKelsey L. Kloberdanz, NPSteve H. Koh, MDMarci L. Kyle, LCSWLauren Mills, PsyDJulie M. Nadeau-Manning, LCSWLauren M. Prasek, NPJennifer S. Sagun, LCSWJoe A. Sepulveda, MDChristie C. Spahr, MFTCelia C. Wolf, NPNot listed3. Who did you see?*I don't rememberCyril Balce, LMFTAleda Barr, RNNicole Bellisario, RNAshraf Fanous, MDKay Freeman, MFTSheila Gleason, PhDHelen Hayden-Wade, PhDLizette Miguel, MACeleste Rios, MAChristie Spahr, MFTCaroline Tamas, MSWMichelle Walker, PsyDCelia Wolf, NPNot listed3. Who did you see?*I don't rememberJennifer Simpson, LCSWAsh Tahbaz, MFTGarrick Tong, MDNot listed3. Who did you see?*I don't rememberAlonso Cardenas, MDTomonori Fukui, MDMartha Jasso, LCSWAsh Tahbaz, MFTNot listed3. Who did you see?*I don't rememberReem Abu-Libdeh, MDDarinka Aragon, MDDuane AuberCharles Banzon, MFTClaudio Cabrejos, MDWendy Dan, LCSWJuan EscalanteCoral Harriman, PhDMariel Janowsky, MDKelsey Kloberdanz, NPBarbara Kuttruff, LCSWLindsay MacMaster, PsyDPatricia Mahoney, LCSWAngela MaldonadoIrlanda Martinez, MAMarisol Martinez, MAAnai MendozaMinera Morales-Moreno, LCSWAshley NelsonJoseph Sepulveda, MDErnie TaimangloJoshua Tartaglione, MDFrancis Ysla, MDJennifer Zimmerman, LCSWNot listed3. Who did you see?*I don't rememberRodrigo Franco, LCSWLupita Ortega, MFTDavid OrtizOlga Yalyshava, LCSWNot listed3. Who did you see?*I don't rememberMichael Alfaro, MARuth Cain, LMFTNot listed3. Who did you see?*I don't rememberJennifer Asuncion, LCSWClaudio Cabrejos, MDRhoda Carino-Diokno, PsyDTamara Halperin, PsyDMaribel LeyvaNot listed3. Who did you see?*I don't rememberMonique Montigny, LCSWNot listed3. Who did you see?*I don't rememberDouglas Aucoin, LCSWDeborah Birnbaum, MDLuz BracamonteMelissa Christensen, LCSWDenise Garcia, MAKate Hudson, LCSWMichael Jones, LCSWMark Knight, MDAshley Leblanc, LCSWHeather Lippert, LCSWCindy Loeb, LCSWRuth Millican, PsyDLizbeth Murillo, MAYuliya Proosaselts, MDNot listed3. Who did you see?*I don't rememberJennifer Asuncion, LCSWShabina Skiles, LCSWNot listed3. Who did you see?*I don't rememberDane Crockford, PsyDMarylupe Flores, LCSWNot listed3. Who did you see?*I don't rememberLeah Aguirre, LCSWRachel Bennet, LCSWJaqueline GutierrezKellsie Michael, LCSWReghabi Naseem, PsyDNot listed4. How was your visit?Very GoodGoodFairPoorVery PoorPlease tell us how we can improve:5. Did you have an appointment?*YesNoHow long did you wait for an appointment?*Same day1 day2 to 3 days4 to 7 daysMore than 7 daysDid you get an appointment reminder?*Phone callText messageNo, I did not6. Were our services affordable?*Very AffordableAffordableNeutralUnaffordableVery Unaffordable7. What can we MOST improve?*Access to CareAppointment AvailabilityAffordabilityCleanliness/AppearanceConfidentialityCustomer ServiceEmpathy/CompassionAccess to Clinic LocationWait TimeOtherNothing, I was pleased with the services.Please describe:8. When at your appointment, how long did you wait until you were seen by a provider?*Less than 10 minutesMore than 15 minutesMore than 45 minutesMore than 60 minutes9. Was the clinic hard to find?*YesNoDid you have difficulty finding parking?*YesNo10. Will you come back again?*YesI don't knowNoPlease tell us why you will not return:11. Would you recommend us to friends and family?*YesI don't knowNoPlease tell us how we can improve:During your most recent visit:12. How friendly was the staff?*Very FriendlyFriendlyNeutralUnfriendlyVery UnfriendlyPlease tell us how we can improve:13. How friendly was the nurse?*Very FriendlyFriendlyNeutralUnfriendlyVery UnfriendlyPlease tell us how we can improve:14. How friendly was the provider?*Very FriendlyFriendlyNeutralUnfriendlyVery UnfriendlyPlease tell us how we can improve:15. Did the provider answer all of your questions?*YesI did not have questionsNoPlease tell us how we can improve:16. Did you feel rushed by the provider?*Not RushedNeutralRushedPlease tell us how we can improve:17. Did you feel respected by the provider?*YesNeutralNoPlease tell us how we can improve:18. What is your age?*18 - 2425 - 3435 - 4445 - 5455 - 6465 - 7475 and olderPrefer not to say19. Are you:*MaleFemaleFTMMTFNon-binary/third genderGender non-conformingPrefer to self-describePrefer not to sayPlease describe:Follow-up question: Did the staff respect your needs related to your gender identity?YesNeutralNoPlease tell us how we can improve:20. What is your sexual orientation?*Straight/HeterosexualGayLesbianBisexualPrefer to self-describePrefer not to sayPlease describe:Follow-up question: Did the staff respect your needs related to your sexual orientation?YesNeutralNoPlease tell us how we can improve:21. What is your ethnicity?*White / CaucasianHispanic or LatinoBlack or African AmericanNative American or American IndianAsian / Pacific IslanderOtherPrefer not to say22. What is the highest grade or level of school that you have completed?*8th grade or lessSome high school but did not graduate/still in high schoolHigh school graduate/GEDSome college or 2-year college degree4-year college degreeMore than a 4-year college degreePrefer not to answer23. What is your household income?*Less than $25,000$25,000 to $34,999$35,000 to $49,999$50,000 to $74,999$75,000 to $99,999$100,000 to $149,999$150,000 or morePrefer not to answer24. How did you hear about us?*Online searchFHCSD websiteSocial MediaFlier, brochure or other printed materialPresentation or table at community eventTalked with a member of FHCSD's outreach teamOutdoor advertisementReferral by friend or family memberReferral from other organizationLong-time FHCSD patientYelp review25. Would you like to provide a testimonial in support of FHCSD's services?*YesNoName:* First Last Email:* Phone:*Please provide your testimonial:*25. We are sorry to hear that you had a less than excellent experience. Would you like us to contact you to address your concerns?*YesNoName* First Last Email* PhonePlease tell us about your experience:*Please copy your testimonial & paste it on our Yelp page.After submitting this form, you will be redirected to our Yelp page.