TBR Stakeholder Survey FY 26 – English

Important Note: This survey is not monitored in real time and should not be used to report immediate concerns or complaints. If you have something that needs attention now, we encourage you to contact your Buckeye Ranch team member.

Date Date / MM / DD YYYY
I am:

I am: The individual receiving services The legal guardian of the individual receiving services A provider, advocate, or other system stakeholder connected to the individual receiving services
What is the race/ethnicity of the individual receiving services?

What is the race/ethnicity of the individual receiving services? American Indian or Alaska Native Asian: Afghan, Asian Indian, Chinese, Filipino, Hmong, Japanese, Korean, Pakistani, Vietnamese, or another group Black Or African American: African American, Congolese, Ethiopian, Ghanian, Haitian, Jamaican, Nigerian, Somali, Tobagonian, Trinidadian, or another group Hispanic or Latino/a: Colombian, Cuban, Dominican, Guatemalan, Honduran, Mexican, Puerto Rican, Salvadoran, Spaniard, or another group Middle Eastern or North African: Egyptian, Iranian, Iraqi, Israeli, Kurdish, Lebanese, Moroccan, Syrian, Yemeni, or another group Native Hawaiian or Pacific Islander: Chamorro, Chuukese, Fijian, Marshallese, Native Hawaiian, Palauan, Samoan, Tahitian, Tongan, or another group White: English, French, German, Irish, Italian, Norwegian, Polish, Scottish Swedish, or another group I prefer not to say
What gender does the individual receiving services identify as?

What gender does the individual receiving services identify as? Male Female Transgender Male Transgender Female Gender Variant/Non-Conforming I prefer not to say
Which program is the individual receiving services from?
If they're in more than 1 program, select 1 and answer questions based on that program.

Which program is the individual receiving services from? If they're in more than 1 program, select 1 and answer questions based on that program. Admissions & Engagement Bonner Academy (Day Treatment) Bridges CME (Care Management Entity, OhioRISE) ECMH (Early Childhood Mental Health) FFT (Functional Family Therapy) Foster Care ICT (Integrated Cognitive Therapy) IFSP (Intensive Family Support Program) IHBT (Intensive Home-Based Therapy) Medication Management MST (Multisystemic Therapy) My Place Outpatient Residential School-Based Program (school services other than Bonner Academy) Somali

Individual Receiving Services:
Individual Receiving Services:	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I was connected to services within the original timeframe I was given.	I was connected to services within the original timeframe I was given.Strongly Agree	I was connected to services within the original timeframe I was given.Agree	I was connected to services within the original timeframe I was given.Neutral	I was connected to services within the original timeframe I was given.Disagree	I was connected to services within the original timeframe I was given.Strongly Disagree
My strengths are seen and included in the services I receive from The Buckeye Ranch.	My strengths are seen and included in the services I receive from The Buckeye Ranch.Strongly Agree	My strengths are seen and included in the services I receive from The Buckeye Ranch.Agree	My strengths are seen and included in the services I receive from The Buckeye Ranch.Neutral	My strengths are seen and included in the services I receive from The Buckeye Ranch.Disagree	My strengths are seen and included in the services I receive from The Buckeye Ranch.Strongly Disagree
I have input in my individual care and treatment plan.	I have input in my individual care and treatment plan.Strongly Agree	I have input in my individual care and treatment plan.Agree	I have input in my individual care and treatment plan.Neutral	I have input in my individual care and treatment plan.Disagree	I have input in my individual care and treatment plan.Strongly Disagree
I am better able to cope when things go wrong.	I am better able to cope when things go wrong.Strongly Agree	I am better able to cope when things go wrong.Agree	I am better able to cope when things go wrong.Neutral	I am better able to cope when things go wrong.Disagree	I am better able to cope when things go wrong.Strongly Disagree
I receive services that are respectful of my lifestyle and/or culture.	I receive services that are respectful of my lifestyle and/or culture.Strongly Agree	I receive services that are respectful of my lifestyle and/or culture.Agree	I receive services that are respectful of my lifestyle and/or culture.Neutral	I receive services that are respectful of my lifestyle and/or culture.Disagree	I receive services that are respectful of my lifestyle and/or culture.Strongly Disagree
I feel respected by The Buckeye Ranch team member working with me.	I feel respected by The Buckeye Ranch team member working with me.Strongly Agree	I feel respected by The Buckeye Ranch team member working with me.Agree	I feel respected by The Buckeye Ranch team member working with me.Neutral	I feel respected by The Buckeye Ranch team member working with me.Disagree	I feel respected by The Buckeye Ranch team member working with me.Strongly Disagree
My Buckeye Ranch team member follows through on what they say they're going to do.	My Buckeye Ranch team member follows through on what they say they're going to do.Strongly Agree	My Buckeye Ranch team member follows through on what they say they're going to do.Agree	My Buckeye Ranch team member follows through on what they say they're going to do.Neutral	My Buckeye Ranch team member follows through on what they say they're going to do.Disagree	My Buckeye Ranch team member follows through on what they say they're going to do.Strongly Disagree
My Buckeye Ranch team member is open and honest when discussing my care.	My Buckeye Ranch team member is open and honest when discussing my care.Strongly Agree	My Buckeye Ranch team member is open and honest when discussing my care.Agree	My Buckeye Ranch team member is open and honest when discussing my care.Neutral	My Buckeye Ranch team member is open and honest when discussing my care.Disagree	My Buckeye Ranch team member is open and honest when discussing my care.Strongly Disagree
My Buckeye Ranch team member tries to understand what I've been through.	My Buckeye Ranch team member tries to understand what I've been through.Strongly Agree	My Buckeye Ranch team member tries to understand what I've been through.Agree	My Buckeye Ranch team member tries to understand what I've been through.Neutral	My Buckeye Ranch team member tries to understand what I've been through.Disagree	My Buckeye Ranch team member tries to understand what I've been through.Strongly Disagree
My Buckeye Ranch team member considers me and my family's needs when planning my care.	My Buckeye Ranch team member considers me and my family's needs when planning my care.Strongly Agree	My Buckeye Ranch team member considers me and my family's needs when planning my care.Agree	My Buckeye Ranch team member considers me and my family's needs when planning my care.Neutral	My Buckeye Ranch team member considers me and my family's needs when planning my care.Disagree	My Buckeye Ranch team member considers me and my family's needs when planning my care.Strongly Disagree
I'm making progress toward my goals.	I'm making progress toward my goals.Strongly Agree	I'm making progress toward my goals.Agree	I'm making progress toward my goals.Neutral	I'm making progress toward my goals.Disagree	I'm making progress toward my goals.Strongly Disagree
My family has people outside The Buckeye Ranch they can turn to for support.	My family has people outside The Buckeye Ranch they can turn to for support.Strongly Agree	My family has people outside The Buckeye Ranch they can turn to for support.Agree	My family has people outside The Buckeye Ranch they can turn to for support.Neutral	My family has people outside The Buckeye Ranch they can turn to for support.Disagree	My family has people outside The Buckeye Ranch they can turn to for support.Strongly Disagree
I'm happy with the services I'm receiving at the Buckeye Ranch.	I'm happy with the services I'm receiving at the Buckeye Ranch.Strongly Agree	I'm happy with the services I'm receiving at the Buckeye Ranch.Agree	I'm happy with the services I'm receiving at the Buckeye Ranch.Neutral	I'm happy with the services I'm receiving at the Buckeye Ranch.Disagree	I'm happy with the services I'm receiving at the Buckeye Ranch.Strongly Disagree
I feel more hopeful about the future.	I feel more hopeful about the future.Strongly Agree	I feel more hopeful about the future.Agree	I feel more hopeful about the future.Neutral	I feel more hopeful about the future.Disagree	I feel more hopeful about the future.Strongly Disagree

Legal Guardian:
Legal Guardian:	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
We were connected to services within the original timeframe we were given.	We were connected to services within the original timeframe we were given.Strongly Agree	We were connected to services within the original timeframe we were given.Agree	We were connected to services within the original timeframe we were given.Neutral	We were connected to services within the original timeframe we were given.Disagree	We were connected to services within the original timeframe we were given.Strongly Disagree
Our family's strengths are seen and included in the services we receive from The Buckeye Ranch.	Our family's strengths are seen and included in the services we receive from The Buckeye Ranch.Strongly Agree	Our family's strengths are seen and included in the services we receive from The Buckeye Ranch.Agree	Our family's strengths are seen and included in the services we receive from The Buckeye Ranch.Neutral	Our family's strengths are seen and included in the services we receive from The Buckeye Ranch.Disagree	Our family's strengths are seen and included in the services we receive from The Buckeye Ranch.Strongly Disagree
We have input in the individual care and treatment plan.	We have input in the individual care and treatment plan.Strongly Agree	We have input in the individual care and treatment plan.Agree	We have input in the individual care and treatment plan.Neutral	We have input in the individual care and treatment plan.Disagree	We have input in the individual care and treatment plan.Strongly Disagree
The individual receiving services is better able to cope when things go wrong.	The individual receiving services is better able to cope when things go wrong.Strongly Agree	The individual receiving services is better able to cope when things go wrong.Agree	The individual receiving services is better able to cope when things go wrong.Neutral	The individual receiving services is better able to cope when things go wrong.Disagree	The individual receiving services is better able to cope when things go wrong.Strongly Disagree
We receive services that are respectful of our lifestyle and/or culture.	We receive services that are respectful of our lifestyle and/or culture.Strongly Agree	We receive services that are respectful of our lifestyle and/or culture.Agree	We receive services that are respectful of our lifestyle and/or culture.Neutral	We receive services that are respectful of our lifestyle and/or culture.Disagree	We receive services that are respectful of our lifestyle and/or culture.Strongly Disagree
We feel respected by The Buckeye Ranch team member working with us.	We feel respected by The Buckeye Ranch team member working with us.Strongly Agree	We feel respected by The Buckeye Ranch team member working with us.Agree	We feel respected by The Buckeye Ranch team member working with us.Neutral	We feel respected by The Buckeye Ranch team member working with us.Disagree	We feel respected by The Buckeye Ranch team member working with us.Strongly Disagree
Our Buckeye Ranch team member follows through on what they say they're going to do.	Our Buckeye Ranch team member follows through on what they say they're going to do.Strongly Agree	Our Buckeye Ranch team member follows through on what they say they're going to do.Agree	Our Buckeye Ranch team member follows through on what they say they're going to do.Neutral	Our Buckeye Ranch team member follows through on what they say they're going to do.Disagree	Our Buckeye Ranch team member follows through on what they say they're going to do.Strongly Disagree
Our Buckeye Ranch team member is open and honest when discussing care.	Our Buckeye Ranch team member is open and honest when discussing care.Strongly Agree	Our Buckeye Ranch team member is open and honest when discussing care.Agree	Our Buckeye Ranch team member is open and honest when discussing care.Neutral	Our Buckeye Ranch team member is open and honest when discussing care.Disagree	Our Buckeye Ranch team member is open and honest when discussing care.Strongly Disagree
Our Buckeye Ranch team member tries to understand what we've been through.	Our Buckeye Ranch team member tries to understand what we've been through.Strongly Agree	Our Buckeye Ranch team member tries to understand what we've been through.Agree	Our Buckeye Ranch team member tries to understand what we've been through.Neutral	Our Buckeye Ranch team member tries to understand what we've been through.Disagree	Our Buckeye Ranch team member tries to understand what we've been through.Strongly Disagree
Our Buckeye Ranch team member considers our family's needs when planning our care.	Our Buckeye Ranch team member considers our family's needs when planning our care.Strongly Agree	Our Buckeye Ranch team member considers our family's needs when planning our care.Agree	Our Buckeye Ranch team member considers our family's needs when planning our care.Neutral	Our Buckeye Ranch team member considers our family's needs when planning our care.Disagree	Our Buckeye Ranch team member considers our family's needs when planning our care.Strongly Disagree
We’re making progress toward our goals.	We’re making progress toward our goals.Strongly Agree	We’re making progress toward our goals.Agree	We’re making progress toward our goals.Neutral	We’re making progress toward our goals.Disagree	We’re making progress toward our goals.Strongly Disagree
I have people outside The Buckeye Ranch that I can turn to for support.	I have people outside The Buckeye Ranch that I can turn to for support.Strongly Agree	I have people outside The Buckeye Ranch that I can turn to for support.Agree	I have people outside The Buckeye Ranch that I can turn to for support.Neutral	I have people outside The Buckeye Ranch that I can turn to for support.Disagree	I have people outside The Buckeye Ranch that I can turn to for support.Strongly Disagree
We're happy with the services we're receiving at the Buckeye Ranch.	We're happy with the services we're receiving at the Buckeye Ranch.Strongly Agree	We're happy with the services we're receiving at the Buckeye Ranch.Agree	We're happy with the services we're receiving at the Buckeye Ranch.Neutral	We're happy with the services we're receiving at the Buckeye Ranch.Disagree	We're happy with the services we're receiving at the Buckeye Ranch.Strongly Disagree
We feel more hopeful about the future.	We feel more hopeful about the future.Strongly Agree	We feel more hopeful about the future.Agree	We feel more hopeful about the future.Neutral	We feel more hopeful about the future.Disagree	We feel more hopeful about the future.Strongly Disagree

Provider, Advocate, or Other System Stakeholder:
	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The individual and family were connected to services within the original timeframe they were given.	The individual and family were connected to services within the original timeframe they were given.Strongly Agree	The individual and family were connected to services within the original timeframe they were given.Agree	The individual and family were connected to services within the original timeframe they were given.Neutral	The individual and family were connected to services within the original timeframe they were given.Disagree	The individual and family were connected to services within the original timeframe they were given.Strongly Disagree
The individual/family's strengths are seen and included in the services they are receiving from The Buckeye Ranch.	The individual/family's strengths are seen and included in the services they are receiving from The Buckeye Ranch.Strongly Agree	The individual/family's strengths are seen and included in the services they are receiving from The Buckeye Ranch.Agree	The individual/family's strengths are seen and included in the services they are receiving from The Buckeye Ranch.Neutral	The individual/family's strengths are seen and included in the services they are receiving from The Buckeye Ranch.Disagree	The individual/family's strengths are seen and included in the services they are receiving from The Buckeye Ranch.Strongly Disagree
The individual, family, and/or other stakeholders have input into the individual's care and treatment plan.	The individual, family, and/or other stakeholders have input into the individual's care and treatment plan.Strongly Agree	The individual, family, and/or other stakeholders have input into the individual's care and treatment plan.Agree	The individual, family, and/or other stakeholders have input into the individual's care and treatment plan.Neutral	The individual, family, and/or other stakeholders have input into the individual's care and treatment plan.Disagree	The individual, family, and/or other stakeholders have input into the individual's care and treatment plan.Strongly Disagree
The individual receiving services is better able to cope when things go wrong.	The individual receiving services is better able to cope when things go wrong.Strongly Agree	The individual receiving services is better able to cope when things go wrong.Agree	The individual receiving services is better able to cope when things go wrong.Neutral	The individual receiving services is better able to cope when things go wrong.Disagree	The individual receiving services is better able to cope when things go wrong.Strongly Disagree
The family receives services that are respectful of their lifestyle and/or culture.	The family receives services that are respectful of their lifestyle and/or culture.Strongly Agree	The family receives services that are respectful of their lifestyle and/or culture.Agree	The family receives services that are respectful of their lifestyle and/or culture.Neutral	The family receives services that are respectful of their lifestyle and/or culture.Disagree	The family receives services that are respectful of their lifestyle and/or culture.Strongly Disagree
The Buckeye Ranch team member I encounter shows respect to the individual and/or family.	The Buckeye Ranch team member I encounter shows respect to the individual and/or family.Strongly Agree	The Buckeye Ranch team member I encounter shows respect to the individual and/or family.Agree	The Buckeye Ranch team member I encounter shows respect to the individual and/or family.Neutral	The Buckeye Ranch team member I encounter shows respect to the individual and/or family.Disagree	The Buckeye Ranch team member I encounter shows respect to the individual and/or family.Strongly Disagree
The Buckeye Ranch team member follows through on what they say they're going to do.	The Buckeye Ranch team member follows through on what they say they're going to do.Strongly Agree	The Buckeye Ranch team member follows through on what they say they're going to do.Agree	The Buckeye Ranch team member follows through on what they say they're going to do.Neutral	The Buckeye Ranch team member follows through on what they say they're going to do.Disagree	The Buckeye Ranch team member follows through on what they say they're going to do.Strongly Disagree
The Buckeye Ranch team member is open and honest when discussing the individual's care.	The Buckeye Ranch team member is open and honest when discussing the individual's care.Strongly Agree	The Buckeye Ranch team member is open and honest when discussing the individual's care.Agree	The Buckeye Ranch team member is open and honest when discussing the individual's care.Neutral	The Buckeye Ranch team member is open and honest when discussing the individual's care.Disagree	The Buckeye Ranch team member is open and honest when discussing the individual's care.Strongly Disagree
The Buckeye Ranch team member tries to understand what the individual and family have been through.	The Buckeye Ranch team member tries to understand what the individual and family have been through.Strongly Agree	The Buckeye Ranch team member tries to understand what the individual and family have been through.Agree	The Buckeye Ranch team member tries to understand what the individual and family have been through.Neutral	The Buckeye Ranch team member tries to understand what the individual and family have been through.Disagree	The Buckeye Ranch team member tries to understand what the individual and family have been through.Strongly Disagree
The Buckeye Ranch team member considers the family's needs when planning their care.	The Buckeye Ranch team member considers the family's needs when planning their care.Strongly Agree	The Buckeye Ranch team member considers the family's needs when planning their care.Agree	The Buckeye Ranch team member considers the family's needs when planning their care.Neutral	The Buckeye Ranch team member considers the family's needs when planning their care.Disagree	The Buckeye Ranch team member considers the family's needs when planning their care.Strongly Disagree
I feel like the individual and/or family is making progress toward their goal(s).	I feel like the individual and/or family is making progress toward their goal(s).Strongly Agree	I feel like the individual and/or family is making progress toward their goal(s).Agree	I feel like the individual and/or family is making progress toward their goal(s).Neutral	I feel like the individual and/or family is making progress toward their goal(s).Disagree	I feel like the individual and/or family is making progress toward their goal(s).Strongly Disagree
The family has people outside The Buckeye Ranch that they can turn to for support.	The family has people outside The Buckeye Ranch that they can turn to for support.Strongly Agree	The family has people outside The Buckeye Ranch that they can turn to for support.Agree	The family has people outside The Buckeye Ranch that they can turn to for support.Neutral	The family has people outside The Buckeye Ranch that they can turn to for support.Disagree	The family has people outside The Buckeye Ranch that they can turn to for support.Strongly Disagree
I'm happy with the services the individual and family are receiving from The Buckeye Ranch.	I'm happy with the services the individual and family are receiving from The Buckeye Ranch.Strongly Agree	I'm happy with the services the individual and family are receiving from The Buckeye Ranch.Agree	I'm happy with the services the individual and family are receiving from The Buckeye Ranch.Neutral	I'm happy with the services the individual and family are receiving from The Buckeye Ranch.Disagree	I'm happy with the services the individual and family are receiving from The Buckeye Ranch.Strongly Disagree
I feel more hopeful for the individual and/or family’s future.	I feel more hopeful for the individual and/or family’s future.Strongly Agree	I feel more hopeful for the individual and/or family’s future.Agree	I feel more hopeful for the individual and/or family’s future.Neutral	I feel more hopeful for the individual and/or family’s future.Disagree	I feel more hopeful for the individual and/or family’s future.Strongly Disagree

What do you like most about the services The Buckeye Ranch has provided?
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What ideas do you have for making things better at The Buckeye Ranch?
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If you would like to shout out any team member for exceptional service or share a success story, we'd love to hear it!
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