100%

Customer Satisfaction

What line did you call in to?

County of residence?

Who did you call in for?

Self

Family Member

Friend

Other

Primary reason for calling ?

Abuse/Victimization

Bullying

Family/Other Relationship

Financial/Basic Needs

Job Loss

Legal

Medical

Mental Health

Self-harm

Sexuality/LGBTQ+

Substance Abuse/Addiction

Suicide

VA/Active Military Related

Other

	Very Dissatisfied	Not Satisfied	Neutral	Satisfied	Very Satisfied
How friendly was the counselor?	Very Dissatisfied	Not Satisfied	Neutral	Satisfied	Very Satisfied

Do you feel the counselor cared about helping you?	Very Dissatisfied	Not Satisfied	Neutral	Satisfied	Very Satisfied

Your crisis was resolved during the call or by the referrals given?	Very Dissatisfied	Not Satisfied	Neutral	Satisfied	Very Satisfied

How likely are you to use the service again and/or refer someone else to the service?	Very Dissatisfied	Not Satisfied	Neutral	Satisfied	Very Satisfied

What was the most helpful?

What was the least helpful?

If you could change one thing about the service, what would it be?

Is there anything you would like the counselor to know that could help the next person they help?

Any other feedback you would like to give?