Client Feedback Survey
Client Feedback Survey
Thank you for taking the time to complete this survey. It is a confidential survey that will better inform our practice and approach while working with clients.
OK
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1.
Did you feel safe, heard, valued and accepted in your therapy sessions?
(Required.)
Yes, 100%
Most of the time
Sometimes
Rarely
Never
Other (please specify)
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2.
Did your clinician communicate treatment expectations and boundaries with you clearly and directly?
(Required.)
Yes 100%
Most of the time
Sometimes
Rarely
Never
Other (please specify)
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3.
Did you feel respect from your clinician towards all aspects of your identity (race, gender, sexual orientation, spirituality/religion, etc.)?
(Required.)
Yes 100%
Most of the time
Sometimes
Rarely
Never
Other (please specify)
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4.
Do you feel that differences in power between you and your clinician went unaddressed and affected the therapy sessions (i.e. differences in gender, race, sexual orientation, etc. greatly impacted your work together)?
(Required.)
Yes 100%
Most of the time
Sometimes
Rarely
Never
Not Applicable
Other (please specify)
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5.
Did you and your clinician work together to create treatment goals?
(Required.)
Yes
Somewhat
No
Other (please specify)
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6.
I have noticed an improvement in my mental health and/or relationships since starting therapy with my clinician
(Required.)
Yes 100%
Somewhat
No
Other (please specify)
7.
Is there anything helpful you have taken away from your therapy sessions (ex: new skills, insights, etc.)?
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8.
How satisfied are you with your experience working with your therapist?
(Required.)
Not Satisfied
1 star
Somewhat Satisfied
2 stars
Satisfied
3 stars
Very Satisfied
4 stars
Extremely Satisfied
5 stars
9.
Is there any other feedback you'd like to share about your therapy experience?
Current Progress,
0 of 9 answered