In-Person Survey
Dear valued client, Dream Life Out Loud is preparing new opportunities to provide you with the best care. This survey is intended to help us plan and should take 3-7 minutes to complete.
Name (optional)
First Name
Last Initial
1. Please select your current therapist?
Please Select
Natasha Wahi, LMHCA
Sarah Orihu, LMFTA
2. Are you interested in seeing your therapist for in-person sessions?
Yes
No
Not sure
If your answer is no (question #2); thank you for your time, you may stop here, but PLEASE scroll down and click the submit button! :)
3. What day of the week you are currently meeting with your therapist virtually?
Monday
Tuesday
Wednesday
Thursday
Friday
4. What day of the week would most likely work best for you for in-person therapy?
Monday
Tuesday
Wednesday
Thursday
Friday
5. How often do you currently meet with your therapist?
Weekly
Bi-weekly (every other week)
Other
6. How often would you like to see your therapist in person?
Weekly
Bi-weekly (every other week)
Monthly
Other
7. Please share how you think in person might impact your progress towards your care/treatment goals?
8. Is there anything else you would like us to know about how you are currently receiving services?
Thank you so much for taking your time to complete this form. The information provided is not shared with anyone outside of our practice and is only viewed by our Operations Team for purposes of gathering information for new service offerings. We look forward to hearing your voice! Thank you.
Submit
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