Surveys
2015
July
A
Adult Case Management Survey\y

Adult Case Management Survey\y

Hello:
You are invited to participate in our survey Adult Case Management. In this survey, approximately 20-30 people will be asked to complete a survey that asks questions about services being provided. It will take approximately 15-20 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Bobby Huey at 910-738-7865 or by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

I Agree

Select the length of time you have been receiving service from this agency.

 Less than 30 days

 Less than 60 days

 Less than 90 days

 More than 90 days

Since being admitted to the service have you come up with...

No personal goals.

A personal goal, but I have not done anything to achieve the goal.

A personal goal and I made a little progress towards achieving it.

A personal goal and I have gotten pretty far in achieving it.

A personal goal and I have achieved it.

How much do you feel you know about symptoms, treatment, coping strategies (coping methods) and medication?

 Not very much.

 A little.

 Some.

 Quite a bit.

 A great deal.

How much are family members and significant others who are important to you involved in you treatment?

 Not at all.

 Only when there is a serious problem.

 Sometimes, such as when things are starting to go badly. Much of the time.

 A lot of the time and they really help with my mental health.

In a normal week, how many times do you talk to someone outside of your family (friend, classmate, roommate, coworker, etc.).

 0 times a week.

 1-2 times a week.

 3-4 times a week.

 5-7 times a week.

How much of your time do you spend working, volunteering, being a student, being a parent, talking to someone else or at someone else’s house or apartment? That is how much time do you spend doing activities that are expected of you for or with another person?

 2 hours or less a week.

 3-5 hours a week.

 6-15 hours a week.

 16-30 hours a week.