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Youth Satisfaction Survey for Families (YSS-F)
YSS-F (rev 20201020)
Youth Services Survey for Families (YSS-F)
Client name
*
First
Last
Client Date of Birth
*
Date Format: MM slash DD slash YYYY
Today's Date
*
Date Format: MM slash DD slash YYYY
Program
*
CGC
FFT
MDFT
IICAPS
Child First
Please select the response that best reflects your level of satisfaction.
1. Overall, I am satisfied with the services my child received.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
2. I helped to choose my child's services.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
3. I helped to choose my child's treatment goals.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
4. The people helping my child stuck with us no matter what.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
5. I felt my child had someone to talk to when he/she was troubled.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
6. I participated in my child's treatment.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
7. The services my child and/or family received were right for us.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
8. The location of services was convenient for us.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
9. Services were available at times that were convenient for us.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
10. My family got the help we wanted for my child.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
11. My family got as much help as we needed for my child.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
12. Staff treated me with respect.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
13. Staff respected my family's religious/spiritual beliefs.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
14. Staff spoke with me in a way that I understood.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
15. Staff were sensitive to my cultural/ethnic background.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
16. As a result of the services my child and/or family received, my child is better at handling daily life.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
17. As a result of the services my child and/or family received, my child gets along better with family members.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
18. As a result of the services my child and/or family received, my child gets along better with friends and other people.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
19. As a result of the services my child and/or family received, my child is doing better in school.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
20. As a result of the services my child and/or family received, my child is better able to cope when things go wrong.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
21. As a result of the services my child and/or family received, I am satisfied with our family life right now.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
22. As a result of the services my child and/or family received, my child is better able to do things he or she wants to do.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
23. As a result of the services my child and/or family received, I know people who will listen and understand me when I need to talk.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
24. As a result of the services my child and/or family received, I have people that I am comfortable talking with about my child's problems.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
25. As a result of the services my child and/or family received, in a crisis I would have the support I need from family or friends.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
26. As a result of the services my child and/or family received, I have people with whom I can do enjoyable things.
*
Strongly agree
Agree
Undecided
Disagree
Strongly disagree
Refused
27. What has been the most helpful thing about the services you and your child received over the last six months?
*
28. What would improve the services here?
*
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