Choice Community Health
Community Health
About us
Services
Supported Employment
Partial Hospitalization
IOP
OMHC
Residential Treatment
Psychiatric Rehabilitation Program
Case Management Services
Mobile Treatment Services (MTS)
SUD – Outpatient Treatment Level 1
Refer to us
Sub Use Treatment Referral Form
ASSERTIVE COMMUNITY TREATMENT SERVICES
CCH Referral PDTP. PHP.. IOP. form
PRP REFERRAL FORM
Work with us
Application Form
Location
Contact us
New Patient Forms
Alcohol Addiction Test
Services Disclosure
Advance Directive for Mental Health Treatment
CCH New Patient Orientation Packet
Survey
Employee Survey
Community Partner Satisfaction Survey
Referral Sources Satisfaction Survey
Get Started
Choice Community Health
REFERRAL SOURCES SATISFACTION SURVEY
REFERRAL SOURCES SATISFACTION SURVEY
Making a referral to Choice Community Health is simple and straightforward.
Agree
Disagree
Dtrongly agree
Strongly disagree
What would make the referral process easier?
How would you rate the customer service you receive when you call Choice Community Health?
Excellent
very good
good
average
poor
When I make a referral to Choice Community Health, I receive a call back in a timely manner regarding acceptance or denial of the referral.
Agree
Disagree
Dtrongly agree
Strongly disagree
Neutral
What is your expectation regarding the timeline for this part of the process?
If my patient has insurance barriers for CCH, offers a thorough explanation and alternative.
My patients seem satisfied with the service they receive from Choice Community Health.
Agree
Disagree
Dtrongly agree
Strongly disagree
Neutral
N/A
The liaison service offered by Choice Community Health makes the discharge process easier for my patients and I.
Agree
Disagree
Dtrongly agree
Strongly disagree
Neutral
N/A
What would make the liaison service better? More or less visibility in your workplace?
Agree
Disagree
Dtrongly agree
Strongly disagree
Neutral
It is easy to reach Choice Community Health after hours to make a referral (on evenings and weekends).
Agree
Disagree
Dtrongly agree
Strongly disagree
Neutral
How would you improve the answering service? Comments?
I would recommend CCH to patients and other providers for services.
Agree
Disagree
Dtrongly agree
Strongly disagree
Neutral
If you would recommend another company, please share why.