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* 1. I felt comfortable and was able to talk about anything with the Therapist.

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* 2. The Therapist was able to address my needs.

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* 3. It is easier for me to attend therapy at my Primary Care Physician's Office.

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* 4. I like that my Doctor and my Therapist are in the same office and able to work together to meet my needs.

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* 5. Having therapy at my Primary Care Physician's office is helpful because (check all that are true):

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* 6. Other positive feedback:

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* 7. Please comment on anything you didn't like or concerns you may have about receiving therapy at your doctor's office:

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* 8. Other comments:

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