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90 Day Assessment
22Questions
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    If more than one, choose all that currently apply
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    This could include illegal drugs or medication not prescribed to you
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    This could include illegal drugs or medication not prescribed to you
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  • 20
    How well do you manage relationships in your life?
    How well are you managing your daily mental health and stress levels?
    How well are you setting boundaries in your life?
    How well do you communicate your needs and feelings to those in your life?
    How well do you think you are accomplishing your initial goals for therapy?
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    1.... not satisfied.... 5 somewhat satisfied.... 10 very satisfied
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    How well do we assist with scheduling appointments with our office?
    How would you describe the process of communication with our office?
    How have you felt about the helpfulness of our staff?
    How would you describe the friendliness of staff?
    How do you feel about the connection with your provider? 
    How satisfied are you with your provider in listening to you and helping you achieve your goals?
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  • 22
    We are constantly working to improve our services to better assist you, your feedback is extremely helpful!
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