Client Satisfaction Survey

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 NameLast Name
Therapist's Name (Optional)

First NameLast Name
The Therapist made me feel comfortable in the session.

Strongly AgreeAgreeNeutralStrongly DisagreeDisagree
My therapist is prompt for sessions (telehealth and/or in-person) with me?

Strongly AgreeAgreeNeutralStrongly DisagreeDisagree
How satisfied are you with the amount of help your therapist provides?

Strongly SatisfiedSomewhat SatisfiedNeutralStrongly DissatisfiedDisatisfied
Therapy helps me deal more effectively with problems that arise.

Strongly AgreeAgreeNeutralStrongly DisagreeDisagree
I receive a reminder of each of my appointments.

Strongly AgreeAgreeNeutralStrongly DisagreeDisagree
What is your overall satisfaction with the scheduling process?

Strongly SatisfiedSomewhat SatisfiedNeutralStrongly DissatisfiedDissatisfied
What is your overall satisfaction with your therapist?

Strongly SatisfiedSomewhat SatisfiedNeutralStrongly DissatisfiedDissatisfied
How long have you been seen by a therapist from Amri Counseling?

Less than 6 monthsAt lease 6 months but less than a yearAt least 1 year but less than 2 yearsAt lease 2 years but less than 3 years3 years
Based on my experience at Amri Counseling, I would refer a friend or family member.

Strongly AgreeAgreeNeutralStrongly DisagreeDisagree
In this final area, please add any comments not addressed in the survey that you think would be helpful. *
Should be Empty: