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Survey Forms

  • Referral Agency List Report by Agency Name or by Referral Code (Updated December 2006)
    DSAMH maintains this list to manage a unique set of identifiers for each treatment unit funded by DSAMH and to provide agencies with a uniform code for referrals. The list has referral code entries for specific agencies as well as codes for generic agency types. Each entry has a referral code and funded programs also contain the agency's treatment unit ID. This list is updated regularly by DSAMH.
  • Consumer Status Survey (Updated December 2006)
    An annual survey to assess the living standards of those Mental Health clients who receive services from the Division.
  • Consumer/Client Satisfaction Survey
    Based on the Mental Health Statistical Improvement Program's MHSIP 28 question survey, this survey is conducted annually to determine the level of satisfaction of the services and facilities provided by the Division.
  • Spanish Version of the Consumer/Client Satisfaction Survey(Updated December 2006)

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Last Updated: Monday July 11 2011
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