Clone of 2024 Parent Survey- Therapy & Care Coordination (for website)

Therapy & Care Coordination Survey

Ramsey County Children's Mental Health Collaborative (RCCMHC)
This survey is about your child's therapy referral and the supports provided by RCCMHC staff
Your feedback and personal stories help us learn how families are using services and how we can make our services better. To thank you for your time, you can enter a raffle at the end of this survey.

Raffle prizes range from $100 to $20

Your survey feedback will be shared with policy makers and funders but we will not use your name. Any phone number or email that you enter for the raffle will remain confidential.
When did you first connect with RCCMHC?*

Less than one month agoOne to six months agoSix months to one year agoMore than one year ago

Comments and Stories
Please share any questions or comments or stories about our staff, services or supports. Your input will help us to improve. Your specific stories also help us to get funding so we can continue offering services. THANK YOU!

Raffle Prizes
If you would like to be entered to win raffle prizes, please type your phone number or email address in this box:
example@example.com

	Not at all	A few days	Several days	More than half of days	Nearly every day
Little interest or pleasure in doing things?
Feeling down, depressed, or helpless?
Feeling nervous, anxious, or on edge?
Not being able to stop or control worrying?

	All of the time	Most of the time	Some of the time	None of the time	Does not apply
How often does your child enjoy school?
How often does your child care about doing well in school?
How often does your child think the things they learn in school are useful?

	Never	Sometimes	Usually	Always	No one in my family has needed care right away
BEFORE working with RCCMHC
NOW

	Never	Sometimes	Usually	Always	Our providers do not need to communicate with each other
BEFORE working with RCCMHC
NOW

Therapy & Care Coordination Survey