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  2. 2015
  3. October
  4. Q
  5. QuestionPro : Services Provided to Consumers
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Exit Survey
 
 
How long have you been receiving our 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
 
 
Do you have contact with family members?
Yes No Sometime Never
 
 
 
 
What age are you?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What best describes your employment status?
 
Employed full-time
 
Employed part-time
 
Self-employed
 
Unemployed, looking for work
 
Unemployed, not looking for work
 
Student
 
Retired
 
Prefer not to answer
 
 
Do you have Children?
1
2
3 or more
None
Prefer not to answer
 
 
 
Do you have a substance problem?
 
Don't know
 
Yes
 
No
 
 
 
If You have a substance abuse problem, how likely are you to continue using?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
What is the highest level of education attained?
 
High School
 
Some College
 
Trade/Vocational/Technical
 
Associates
 
Bachelors
 
Masters
 
Professional
 
Doctorate
 
 
 
Do you have any suggestions for improvement?
   
 
 
 
If group workshops were offered, would you participate?
 
Yes
 
No
 
Sometime
 
Maybe
 
Depends
 
 
 
Would you like to participate in other activities offered?
 
Yes
 
No
 
Depends
 
 
 
What type of activities would you like to participate in?
 
Job Search
 
Resume Writing
 
Exercise Class
 
Journal Writing
 
Library on Premises
 
Other
 
 
 
 
Has this survey been useful for you?
 
Yes
 
No
 
Somewhat
 
Not at all