Download the PDF version of the "2013 Customer Satisfaction Form" (602 KB).

The Substance Abuse and Mental Health Services Administration (SAMHSA) wants to know about your National Recovery Month (Recovery Month) efforts this September and year round. Use the below form to let us know how useful the Recovery Month toolkit materials were in building awareness about prevention, treatment, and recovery. This information will be used in the development of future materials distributed by SAMHSA, within the U.S. Department of Health and Human Services (HHS).

While your response is voluntary, it is essential in order to improve future Recovery Month materials to better meet your needs. Please complete this form and return it by mail or fax to the address at the end of the form by December 31, 2013. SAMHSA encourages you to include photographs and/or samples of supporting materials from your Recovery Month activities.

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