Language
English (US)
Client Satisfaction Survey
Please take a few minutes to complete survey. Your specific answers will be completely anonymous, unless you choose to type your name below. Your views, in combination with those of others, are extremely important. Thank you for taking survey with Amri Counseling.
Client's Name (Optional)
First Name
Last Name
Therapist's Name (Optional)
First Name
Last Name
The Therapist made me feel comfortable in the session.
Strongly Agree
Agree
Neutral
Strongly Disagree
Disagree
My therapist is prompt for sessions (telehealth and/or in-person) with me?
Strongly Agree
Agree
Neutral
Strongly Disagree
Disagree
How satisfied are you with the amount of help your therapist provides?
Strongly Satisfied
Somewhat Satisfied
Neutral
Strongly Dissatisfied
Disatisfied
Therapy helps me deal more effectively with problems that arise.
Strongly Agree
Agree
Neutral
Strongly Disagree
Disagree
I receive a reminder of each of my appointments.
Strongly Agree
Agree
Neutral
Strongly Disagree
Disagree
What is your overall satisfaction with the scheduling process?
Strongly Satisfied
Somewhat Satisfied
Neutral
Strongly Dissatisfied
Dissatisfied
What is your overall satisfaction with your therapist?
Strongly Satisfied
Somewhat Satisfied
Neutral
Strongly Dissatisfied
Dissatisfied
How long have you been seen by a therapist from Amri Counseling?
Less than 6 months
At lease 6 months but less than a year
At least 1 year but less than 2 years
At lease 2 years but less than 3 years
3 years
Based on my experience at Amri Counseling, I would refer a friend or family member.
Strongly Agree
Agree
Neutral
Strongly Disagree
Disagree
In this final area, please add any comments not addressed in the survey that you think would be helpful.
*
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