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MATRIX FIDELITY QUESTIONS ASSESMENT 1: WEEKS 1-4

Today's Date: Please Enter Today's Date

MonthDayYear




WAMHSAC Provider.

What WAMHSAC Provider Are You From?

PWC CWCC
NWMHC Curran-Seeley
FCS EWMHC
HCC CMC


Groups

What group is this for?

M1. How many relapse prevention groups were held the past month?
Four or less RP Groups in four weeks
Five RP Groups in four weeks
Six RP Groups in four weeks
Seven RP Groups in four weeks
Eight RP Groups in four weeks

M2. How many family education groups were held the past month?

No FE groups were held in four weeks
One FE group was held in four weeks
Two FE Groups were held in four weeks
Three FE Groups were held in four weeks
Four FE Groups were held in four weeks

M3. How many early recovery skills groups were held in the first four weeks of treatment?

Four or less ER groups were held.
Five ER groups were held
Six ER groups were held
Seven ER groups were held
Eight ER groups were held

THANK YOU!


This questionnaire was created using Perseus SurveySolutions.

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