Outreach Satisfaction Survey

Outreach Survey
At the OCD Anxiety Centers, it is important for us to learn your opinions so we may serve referring professionals, clients, and future clients.

For the following statements, please select how much you agree with them (from strongly agree to strongly disagree).
Who is the representative you speak to?
The process for making a referral was easy and efficient.*

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
The representative was knowledgeable and helpful.*

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Based on my experience thus far, I would refer a client to OCD Anxiety Centers.*

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Based on my experience thus far, I would recommend OCD Anxiety Centers to another referring professional or organization.

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Overall, my interactions with my Clinical Outreach Specialist are positive.

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1 is , 10 is Best
Would you like a member of our team to reach out to you?

YesNo
Contact Name

First NameLast Name
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Outreach Survey