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Survey Forms

  • Referral Agency List Report (by Agency Name (Text Version) or by Referral Code (Text Version) ) (Updated September 5, 2003)
    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 August 5, 2004)
    An annual survey to assess the living standards of those Mental Health clients who receive services from the Division. Text Version
  • Consumer/Client Satisfaction Survey (Updated June 21, 2003)
    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. Text Version


Some of the files above are in Adobe Acrobat format. You can view them with Adobe Acrobat Reader. For your free copy please visit Acrobat Download Adobe Acrobat Reader If you are using an assistive technology unable to read Adobe PDF, please visit Adobe's Accessibility Tools page.
Last Updated: Friday November 03 2006
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