ACCOUNT-ABILITY FORM
In regards to your last session:
How are you feeling physically and emotionally?
Did you feel like your boundaries were respected? If not, please elaborate.
Did you feel safe and supported? If not, please provide details.
Was there anything that made you uncomfortable? If yes, please elaborate.
Did a conflict occur? If yes, please provide details.
Did the session meet your expectations? If not, please elaborate.
Is there anything you would like to work on in a future session?
Do you have any feedback, comments or suggestions?
Would you like to be contacted to further discuss any of your responses on this form? If yes, would you like to be contacted by Meredith or one of her Account-ability Peers? If yes, how would you like to be contacted?
Name (not required)
Date of Session (not required)
How would you rate your experience?
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