The Palm Beach Institute
Client Satisfaction Survey
Today’s date:
The following questionnaire will be used as a tool to evaluate the treatment you received at The Palm Beach Institute (PBI). PBI is committed to providing the highest quality treatment possible; for this reason, your feedback is very important, it will help us to improve our treatment program and PBI as a whole.
Please do not put your name on the questionnaire, be as direct as possible; all information that you share will remain completely confidential. When you complete the questionnaire, please return to the Alumni Coordinator or Case Manager.
During your stay, which programs did you utilize?
Detox________ Adolescent________ RTC/PHP________ Olive House________
Please rate each area on the table below:
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Excellent |
Good |
Average |
Poor |
Not Apply |
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Please rate overall experience at PBI: |
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Intake Department (Prior to your admission): |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Who was your Intake Counselor:_____________________________ |
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Promptness of return call |
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Availability |
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Helpfulness |
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Please rate overall intake experience: |
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Admission/Intake: |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Who was your Admission Counselor:_________________________ |
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Prompt assistance upon arrival |
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Explained all documentation clearly & answered all questions |
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Please rate overall admission/business office experience: |
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Medical/Psychiatric: |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Please rate Physician and/or Physician’s Assistant |
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Please rate Nursing Staff |
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Personal Caring |
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Availability |
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Assistance in understanding treatment process |
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Explanation of test & test results |
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Care of physical problems |
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Care of psychiatric problems |
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Professionalism in medical care |
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Assistance in understanding medications |
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Please rate overall Medical/Psychiatric experience: |
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Counseling: |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Who is/was your Primary Therapist:__________________________ |
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Rapport with therapist |
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Caring & helpfulness of counselors |
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Helpful interaction with therapist |
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Well run therapeutic sessions |
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Family involvement |
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Scheduling/keeping appointments |
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Guidance in looking at self |
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Assistance in treatment planning |
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Assistance in explaining recovery principles |
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Assistance in applying recovery steps |
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Felt validated and listened to by therapist |
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Treated with respect and dignity by therapist |
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Freedom to express my frustrations with therapist |
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Able to express my individuality |
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Please rate your overall experience in counseling: |
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Program Components: |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Consistent, fair program rules |
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12 Step Programming |
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Group counseling |
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Individual counseling |
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Books, Literature, Handouts |
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Written assignments |
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Fitness |
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Enjoyable recreation activities |
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Aftercare planning |
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AA/NA Meetings |
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Information on spirituality |
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Art Therapy |
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Family Workshop |
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School time |
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Please rate overall Program Components: |
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Non-medical staff (BHTs) |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Competent |
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Caring |
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Freedom to express my frustrations with techs |
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Felt validated and listened to by the techs |
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Treated with respect and dignity by techs |
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Knowledge of programs and recovery steps |
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Please rate your overall experience with BHT’s(Techs): |
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Facility Accommodations: |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Quietness |
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Safe, Confidential Environment |
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Cleanliness |
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Lighting |
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Maintenance of Facility & Equipment |
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Maintenance of grounds |
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Comfort |
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Please rate overall living accommodations: |
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Dining: |
Excellent |
Good |
Average |
Poor |
Not Apply |
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Quality of food |
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Quantity of food |
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Balanced meals |
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Variety |
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Cleanliness of dinnerware/utensils |
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Cleanliness of dining area |
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Special diet/nutritional needs met |
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Patient Safety: |
Strongly Agree |
Agree |
Neutral |
Disagree |
Strongly Disagree |
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I was informed of the purpose and nature of tests, treatment, procedures and medications. |
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I was given the opportunity to ask questions or seek further information if I was unsure of anything pertaining to my care. |
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Staff confirmed my identity prior to performing tasks or procedures, or giving me medications. |
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Staff appeared to take the proper time and safety precautions while caring for me. |
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I perceive that I was provided with safe and competent care. |
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1. Prior to your admission to this program, what were your expectations of The Palm Beach Institute? |
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2. How have your expectations changed? |
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3. What do you consider to be the main strengths of the program? |
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4. Where did you hear about our program? |
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Therapist |
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12-Step meeting |
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Friend |
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Psychiatrist |
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Media |
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Conference |
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Alumni |
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Internet |
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Other |
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5. Did you consider any other treatment program before choosing PBI; if yes, what program/s? |
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6. What were the major reasons you chose PBI for treatment? |
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Programming |
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Cost |
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Number of patients |
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Location |
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Was not our choice |
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Other |
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7. How did you pay for your treatment? |
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Cash |
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Combination of both |
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Insurance |
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8. How old are you? |
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13 – 17 |
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30 – 39 |
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50 – 59 |
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18 – 29 |
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40 – 49 |
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60 and over |
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9. What city, state and/or country do you reside? |
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10. Would you choose PBI again? |
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Yes |
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No |
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Why or why not? |
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11. Is there a staff person that you would like to recognize that gave you exceptional care while in treatment at PBI? |
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12. If you rated anything below an Average/Neutral on the above survey, please explain what you would like to see improved: |
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Please share any additional comments or suggestions you may have to improve our care:
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