directions
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Directions: Please select the appropriate answer for each question based on your experience today. When complete, please click submit below., type: esriFieldTypeString
)
clinic_program
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Clinic and/or Program I visited today:, type: esriFieldTypeString
)
information_received
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: The information I received today was useful., type: esriFieldTypeString
, Coded Values:
[😁 Strongly Agree: 😁 Strongly Agree]
, [🙂 Agree: 🙂 Agree]
, [😶 Neutral: 😶 Neutral]
, ...2 more...
)
substance_use_services
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I am aware that substance use services are available for children, adolescents, and adults., type: esriFieldTypeString
, Coded Values:
[😁 Strongly Agree: 😁 Strongly Agree]
, [🙂 Agree: 🙂 Agree]
, [😶 Neutral: 😶 Neutral]
, ...2 more...
)
community_services
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I know how to access community services and supports (such as Clubhouses and Prevention and Early Intervention [PEI] Programs), type: esriFieldTypeString
, Coded Values:
[😁 Strongly Agree: 😁 Strongly Agree]
, [🙂 Agree: 🙂 Agree]
, [😶 Neutral: 😶 Neutral]
, ...2 more...
)
grievance_info
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I have been given information on who to contact if I have a concern/complaint/grievance., type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
)
twenty_four_hour_service
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I have been given a phone number to call if I need 24-hour services., type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
)
anything_else
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please explain if you Disagree/Strongly Disagree to any of the statements. Is there anything else you would like to tell us about your experience today?, type: esriFieldTypeString
)
optional
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Optional: Would you like a Department of Behavioral Health (DBH) representative to contact you about your experience during this visit? If yes, please complete the following:, type: esriFieldTypeString
)
language_services
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I was provided information on receiving services in my preferred language if I needed them (e.g., ASL, Spanish, Mandarin, Vietnamese)., type: esriFieldTypeString
, Coded Values:
[😁 Strongly Agree: 😁 Strongly Agree]
, [🙂 Agree: 🙂 Agree]
, [😶 Neutral: 😶 Neutral]
, ...2 more...
)
first_visit
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is this your first visit to this clinic/program?, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
)
greeted_entry
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Were you greeted upon entry?, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
)
grievance_complain
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If you would like to submit a grievance or complaint, please request a form from your provider or call the Access Unit (Behavioral Health Helpline) toll-free at (888) 743-1478 or visit the website https://wp.sbcounty.gov/dbh/consumerforms/ , type: esriFieldTypeString
)