Provider Quarterly Program Survey - Boris Lawrence Henson Foundation

Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Strongly AgreeItem #3 Strongly Agree	AgreeItem #3 Agree	NeutralItem #3 Neutral	DisagreeItem #3 Disagree	Strongly DisagreeItem #3 Strongly Disagree

Very Helpful	Slightly Helpful	Not Helpful
Very HelpfulItem #3 Very Helpful	Slightly HelpfulItem #3 Slightly Helpful	Not HelpfulItem #3 Not Helpful

Overall Satisfaction:

How satisfied were you with

	Very Satisfied	Satisfied	Neutral	Unsatisfied	Very Unsatisfied
The responsiveness of the BLHF team to your inquiries or needs	Very SatisfiedThe responsiveness of the BLHF team to your inquiries or needs Very Satisfied	SatisfiedThe responsiveness of the BLHF team to your inquiries or needs Satisfied	NeutralThe responsiveness of the BLHF team to your inquiries or needs Neutral	UnsatisfiedThe responsiveness of the BLHF team to your inquiries or needs Unsatisfied	Very UnsatisfiedThe responsiveness of the BLHF team to your inquiries or needs Very Unsatisfied
The quality of interactions with BLHF team members regarding support, communication, and problem-solving	Very SatisfiedThe quality of interactions with BLHF team members regarding support, communication, and problem-solving Very Satisfied	SatisfiedThe quality of interactions with BLHF team members regarding support, communication, and problem-solving Satisfied	NeutralThe quality of interactions with BLHF team members regarding support, communication, and problem-solving Neutral	UnsatisfiedThe quality of interactions with BLHF team members regarding support, communication, and problem-solving Unsatisfied	Very UnsatisfiedThe quality of interactions with BLHF team members regarding support, communication, and problem-solving Very Unsatisfied
The communication from BLHF regarding updates and information	Very SatisfiedThe communication from BLHF regarding updates and information Very Satisfied	SatisfiedThe communication from BLHF regarding updates and information Satisfied	NeutralThe communication from BLHF regarding updates and information Neutral	UnsatisfiedThe communication from BLHF regarding updates and information Unsatisfied	Very UnsatisfiedThe communication from BLHF regarding updates and information Very Unsatisfied
Invoicing for services rendered	Very SatisfiedInvoicing for services rendered Very Satisfied	SatisfiedInvoicing for services rendered Satisfied	NeutralInvoicing for services rendered Neutral	UnsatisfiedInvoicing for services rendered Unsatisfied	Very UnsatisfiedInvoicing for services rendered Very Unsatisfied
Number of clients referred	Very SatisfiedNumber of clients referred Very Satisfied	SatisfiedNumber of clients referred Satisfied	NeutralNumber of clients referred Neutral	UnsatisfiedNumber of clients referred Unsatisfied	Very UnsatisfiedNumber of clients referred Very Unsatisfied
Navigating the BLHF Let's Talk! Resource Guide webpage	Very SatisfiedNavigating the BLHF Let's Talk! Resource Guide webpage Very Satisfied	SatisfiedNavigating the BLHF Let's Talk! Resource Guide webpage Satisfied	NeutralNavigating the BLHF Let's Talk! Resource Guide webpage Neutral	UnsatisfiedNavigating the BLHF Let's Talk! Resource Guide webpage Unsatisfied	Very UnsatisfiedNavigating the BLHF Let's Talk! Resource Guide webpage Very Unsatisfied
Information from BLHF about upcoming initiatives, programs and events	Very SatisfiedInformation from BLHF about upcoming initiatives, programs and events Very Satisfied	SatisfiedInformation from BLHF about upcoming initiatives, programs and events Satisfied	NeutralInformation from BLHF about upcoming initiatives, programs and events Neutral	UnsatisfiedInformation from BLHF about upcoming initiatives, programs and events Unsatisfied	Very UnsatisfiedInformation from BLHF about upcoming initiatives, programs and events Very Unsatisfied

Please identify whether you have engaged with any of the following BLHF activities and for each you have engaged with

Resource Guide Ambassadors Program
Quarterly Meet-Up
Cultural Humility Training
Integrated Wellness Event

Please identify your level of satisfaction with the Resource Guide Ambassadors Program

Very Satisfied	Satisfied	Neutral	Unsatisfied	Very Unsatisfied
Very SatisfiedItem #1 Very Satisfied	SatisfiedItem #1 Satisfied	NeutralItem #1 Neutral	UnsatisfiedItem #1 Unsatisfied	Very UnsatisfiedItem #1 Very Unsatisfied

Please identify your level of satisfaction with the Quarterly Meet-Up

Very Satisfied	Satisfied	Neutral	Unsatisfied	Very Unsatisfied
Very SatisfiedItem #1 Very Satisfied	SatisfiedItem #1 Satisfied	NeutralItem #1 Neutral	UnsatisfiedItem #1 Unsatisfied	Very UnsatisfiedItem #1 Very Unsatisfied

Please identify your level of satisfaction with the Cultural Humility Training

Very Satisfied	Satisfied	Neutral	Unsatisfied	Very Unsatisfied
Very SatisfiedItem #1 Very Satisfied	SatisfiedItem #1 Satisfied	NeutralItem #1 Neutral	UnsatisfiedItem #1 Unsatisfied	Very UnsatisfiedItem #1 Very Unsatisfied

Please identify your level of satisfaction with the Integrated Wellness Event

Very Satisfied	Satisfied	Neutral	Unsatisfied	Very Unsatisfied
Very SatisfiedItem #1 Very Satisfied	SatisfiedItem #1 Satisfied	NeutralItem #1 Neutral	UnsatisfiedItem #1 Unsatisfied	Very UnsatisfiedItem #1 Very Unsatisfied

How likely are you to

	Likely	Neutral	Unlikely
Continue working as a mental health provider in partnership with the BLHF	LikelyContinue working as a mental health provider in partnership with the BLHF Likely	NeutralContinue working as a mental health provider in partnership with the BLHF Neutral	UnlikelyContinue working as a mental health provider in partnership with the BLHF Unlikely
Encourage other clinicians to join the BLHF Let’s Talk Resource Guide	LikelyEncourage other clinicians to join the BLHF Let’s Talk Resource Guide Likely	NeutralEncourage other clinicians to join the BLHF Let’s Talk Resource Guide Neutral	UnlikelyEncourage other clinicians to join the BLHF Let’s Talk Resource Guide Unlikely
Recommend BLHF services to potential clients	LikelyRecommend BLHF services to potential clients Likely	NeutralRecommend BLHF services to potential clients Neutral	UnlikelyRecommend BLHF services to potential clients Unlikely

Overall, how satisfied are you with your collaboration with BLHF?

Please provide any additional comments or suggestions to improve our collaboration.

Impact on Service Quality

Overall Satisfaction:

Emergency? Please Call 988.

Impact on Service Quality

Overall Satisfaction:

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