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Client Satisfaction Survey
It is very important to us that your service was professional and helpful. Once you are no longer a client, please complete this form. Your answers are confidential and will be used to improve service.
*
Indicates required field
How long were you in treatment?
*
1-3 months
4-7 months
8-12 months
12+ months
What were you in treatment for? Check all that were addressed in your sessions.
*
Anxiety
Depression
OCD
Stress
Work concerns
Grief
Other
Did you attend your scheduled sessions?
*
About 100% of the time
I occasionally missed my sessions
I frequently missed my sessions
I missed most of my scheduled sessions
What is your age?
*
Less than 13
13-18
19-25
26-35
36-50
Over 50
Prefer not to say
What were in treatment to address?
*
Anxiety
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
Prefer not to say
Submit
Home
About - Insurance - Fees
Secure Client Portal
Groups - Events
Training & Education
Services
Contact
Blog
Referrals