Mental Health Patient Satisfaction Survey

This form pertains to the counseling services that you receive through Holland Free Health Clinic. This survey was designed to continue to better the mental health program and best assist you as you continue and complete counseling. Please complete the survey honestly and constructively. Thank you for utilizing Holland Free Health Clinic. Please contact us with any questions at (616) 392-3610.

Please gauge the status of your mental health today in comparison to how it was prior to receiving counseling at HFHC. *

Please comment on what aspects of the program are most helpful and/or enjoyable to you: *

What could we do in the future to improve this program? What is the least helpful? *

Would you feel comfortable giving HFHC permission to share your story, comments, and feelings about this program in promotional materials? **Your name and information will be kept confidential, unless you select YES** *

Yes No

HFHC Mental Health Patient Satisfaction Survey