Active Service Survey - Caregiver

Your feedback on the services at Intersect is important. We use this information to make sure we are meeting your needs in a meaningful way, to identify areas we can improve on and to plan for the future.

What to know about this survey:

You do not have to participate in this survey if you don’t want to.
Your responses are anonymous and confidential; you do not have to record your name.
Your answers will not affect your ability to access services at Intersect.

Please fill out as much information as possible.

Date: (mm/dd/yyyy)

Child/Youth's Information

Age:

Gender:

Ethnicity:

Person completing the Survey Information

Relationship to child / youth:

The total number of sessions my child/youth and I have attended so far is (best guess):

What services did you get from Intersect while you were on the waitlist:

Information

Referral to other services

Crisis Support

Group

None

What did you appreciate the most about your time here today?

Do you have any suggestions to make our intake services better?

Is there anything else you would like to share with us?

Important: Click the "I'm not a robot" checkbox above, before clicking the 'SEND' button.

First-time intake appointment Satisfaction Survey:

Surveys for those currently receiving Intersect services:

Survey for service providers in Prince George that work with Intersect:

Community Stakeholder Survey

Active Service Survey - Caregiver

Your feedback on the services at Intersect is important. We use this information to make sure we are meeting your needs in a meaningful way, to identify areas we can improve on and to plan for the future.

Date: (mm/dd/yyyy)

Child/Youth's Information

Person completing the Survey Information

Please specify the following services you and your child / youth have accessed at Intersect:

Individual therapy/counselling

Family therapy

EFFT parent work

Psychiatry

Psychology

Intersect School Program

Groups

Referrals to other services

If you and/or your child/youth have attended groups, which ones did you attend?

What services did you get from Intersect while you were on the waitlist:

Please indicate how much you agree with the following statements:

I have been included in the assessment of my child/youth's mental health.

I know what the Individual Service Plan/Mental Health Goals are.

I have been included in Individual Service Planning/Mental Health Goal setting.

I understand what confidentiality is.

My child/youth's culture and religious beliefs are respected.

My child/youth’s gender and sexual orientation are respected.

We have made progress toward our goals since coming to Intersect.

My child/youth has more healthy and effective coping skills since coming to Intersect.

My family has been able to talk about emotions more effectively since coming to Intersect.

My relationship with my child/youth/family has improved.

I have a greater understanding of what my child/youth is going through.

I know about other resources in the community that can help my child/youth/family.

I feel supported by my child/youth's counsellor/therapist in community meetings (i.e. school, hospital, etc.).

I am aware of when my family should expect to have completed counselling/therapy.

I know what to do if I have a concern or complaint about the services my family receives at Intersect.

I worry about people knowing my child/youth comes to Intersect.

I feel safe while at Intersect.

I feel respected while at Intersect.

I feel comfortable while at Intersect.

I feel more hopeful since coming to Intersect.

I would refer my friends/family to Intersect.

Please rate your level of satisfaction with the following:

The hours Intersect is open.

The appearance and cleanliness of the building.

The physical accessibility of the building (e.g. ramps, stairs, etc.).

The length of time we were on the waitlist.

The time of day when services were scheduled.

Confidentiality.

The courtesy and respectfulness of staff.

Psychology services.

Psychiatry services.

Groups you attended.

Intersect School Program.

Counselling/Therapy services.

Website content.

Overall, how satisfied are you with the quality of services you have received so far?

What did you appreciate the most about your time here today?

Do you have any suggestions to make our intake services better?

Is there anything else you would like to share with us?

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