This quality improvement project employed a client-centered process to develop a modified Client Satisfaction Questionnaire (CSQ) 10 (Larsen, Attkisson, Hargreaves, & Nguyen, 1979) for relevance to our hospital-based violence intervention progrma (HVIP). Former clients (ages 11 12-18) and caregivers who participated in HVIP services self-administered the initial HVIP-adapted CSQ and shared their interpretation of questionnaire items, comfort in responding, missing topics, and preferences for implementation during cognitive interviews. This work met the criteria as a quality improvement activity by our local IRB and did not require IRB approval or determination. We have adhered to the SQUIRE guidelines in preparing this manuscript.