Referral Source Survey If you have referred to us, please provide us with your feedback on the referral process. All fields are required to submit this survey. Organization:required Position within Organization:required Approximate or actual number of referrals or common consumers with Catalyst Life Services within the last year: (Please check appropriate response)required Less than 1010-2526-50Over 50 How easy is it to refer consumers to our agency for treatment?required PoorFairAverageAbove AverageExcellent How well do we provide general information about our agency to you?required PoorFairAverageAbove AverageExcellent How well do we give feedback to you on consumers referred?required PoorFairAverageAbove AverageExcellent The next questions are open ended for more detailed feedback: Is our referral process understandable?required What could we improve about ourselves as an agency?required What further information could we provide you to enhance your knowledge of our agency?required What do we do well as an agency?required Please provide us with suggestions for improving access in all the areas discussed.required Please identify any staff persons who particularly stand out as exemplary employees.required Δ