ROH Client Satisfaction Survey

ROH Client Satisfaction Survey
My assigned Therapist is?

Please rate how strongly you satisfied with each of the statements.

	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied	Not Applicable
Professionalism of the Therapist.
I can see, hear and understand my Therapist while online.
My Therapist discussed information about reporting abuse and neglect & Self Harm/Harm to Others.
I was able to express my needs and expectations for therapy.
In my initial session I was told I would be evaluated for a diagnosis and potential treatment goals.
I feel comfortable working with my Therapist.
I feel like my therapeutic needs are being addressed.
There are minimal distractions in my Therapists background during my sessions.

Overall, how satisfied are you with your therapeutic experience?

Please rate how strongly you agree or disagree with each of the statements.

	Totally Disagree	Somewhat Disagree	Somewhat Agree	Totally Agree	Not Applicable
The Theranest Portal is easy to navigate.
I have knowledge about my copay or deductible.
I have been educated about the cancellation policy and associated fees.
I have been able to ask questions as needed.
The on-boarding process for therapy went by smoothly.
I would refer my friends, family or colleagues.

How likely are you to continue to participate in our services?

Very likelyLikelyNot likelyNot likely at allNot knowOther
Do you have any other feedback regarding your Therapist or Rivers of Healing?
Should be Empty: