Substance Abuse Program Client Feedback Form
Client Information
Name
Date
Email
Program Experience
How would you rate your overall experience in the program?
Excellent
Good
Average
Poor
Were the program goals and expectations clear to you?
Yes
No
Did you feel supported by the staff?
Always
Most of the time
Sometimes
Never
What aspect of the program was most helpful for you?
What improvements would you suggest for the program?
Additional Comments