Peguis Al-Care Survey Questionnaire

Peguis Al-Care Treatment Centre Survey/Questionnaire

Your answers to the following questions will help guide us in the services that we provide/offer. The survey will be used as a guide and the responses will be confidential. Please circle your answers.

  1.   What is your age?           18-25            26-35      46-55     56-65    65+
  2. Do you live in Peguis?      Yes          No
  3. How long have you lived in Peguis?        0-5 yrs.          5-10 yrs.          10-20 yrs.     20+yrs.
  4. Have you ever attended a treatment centre?      Yes        No
  5. Have you ever been to our centre?      Yes       No
  6. If yes, when were you here?        2016       2015    2014    2013  2012   2011    2010     before 2009
  7. Are you aware that we offer over 20 programs, while in treatment?      Yes     No
  8. These are some of the programs that we offer in the centre. How important are the following programs for one to learn about? (Check one box that applies to each factor).
Very Important Important Somewhat Important Not at all Important No Opinion
Cost of Addiction
Healthy Relationships
Communication Skills
Family Violence
Anger Management
Parenting Program
Loss & Grieving
Life Skills
Lateral Violence
Traditional Teachings
Exercise Program
Art Therapy
Resume Writing
Refusal Skills
Time Management
Personal Hygiene
Land Based Healing
Medicine Picking

9.   What program(s) do you think we should offer?


10. Did you know that we offer a Day Treatment Program?    Yes   No

11.  Would you attend an Information Session on our                                    Residential & Day Programs, if we offered one?       Yes     No     Maybe

12.  Do you believe the Centre has improved over the past five years?     Yes         No

13.    Would you like to receive future information or newsletters on the centre?     Yes        No

14.  Do you any further suggestions or comments?


Thank you for taking the time to complete our survey. The information you have provided will be considered for future programming, to ensure that we meet the needs of the clients that we serve.

Should you have any questions or concerns, please feel free to call the centre at any time.