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2012
January
Q
QuestionPro : Services Provided to Consumers
QuestionPro : Services Provided to Consumers
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How long have you been aware that you are in need of residential services?
Less than 6 months
6 months to less than 1 year
1 year to less than 3 years
3 years to less than 5 years
5 years or more
How often do you use alcohol? Drugs? or any other mind and mood altering chemical?
Don't Use
Daily
Weekly
Monthly
Quarterly
Alcohol
Crack/Cocaine
Heroin/Methadone
Marijuana
Prescription Medication
Which of our services do you feel would help you best?
Faith-based structuring?
Critical Thinking Groups?
Individual Counseling?
Life Coaching?
Job Readiness training?
Motivational Seminars?
Other
Based upon your introduction to Rhama Word House. How confident are you with us?
Highly satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Highly dissatisfied
How do we rate on the following attributes?
Well Below Average
Below Average
Average
Above Average
Well Above Average
Knowledge
Access
Professionalism
Services offered
Quality of service
Understanding of customers' needs
How do we rate in comparison to other organizations that offer the same services?
Much higher
Somewhat higher
Same
Somewhat lower
Much lower
Don't know
How likely are you to tell others about Rhama Word House?
Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely
Have you ever lived in a residential program before?
No,
Once or twice
More than twice
Do you have any fears of living in a residential program?
Are you on any form of medication that requires monitoring?
Have you had any mental illness which required physician treatment?
What is your religous beliefs?
Christianity
Other religion
Prefer not to answer
What is your age?
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
What is your source of income?
Employed full-time
Employed part-time
Self-employed
SSI
Trust Fund
Student
Retired
Homemaker
Military
Prefer not to answer
Other
Which of the following categories best describes your annual income?
Under $15,000
$15,000 - $29,999
$30,000 - $44,999
$45,000 - $59,999
$60,000 - $74,999
$75,000 - $89,999
$90,000 or more
Prefer not to answer
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