Physician Wellness Program Member Satisfaction Survey
The responses to the survey are anonymous and responses cannot be tracked back to a specific individual, unless you would like to be quoted by name on question 10.
1. The problems, feelings, or situation that brought me to therapy are:
Much Improved
Improved
About the Same
Worse
Much Worse
2. Because of therapy, I feel better equipped to manage them in the future.
Strongly Agree
Agree
Uncertain
Disagree
Strongly Disagree
3. My therapist was _____________.
Very Helpful
Somewhat Helpful
Somewhat Unhelpful
Very Unhelpful
4. What in particular caused you to answer #2 and #3 the way you did?
5. If I knew a colleague who needed help in the future, I would feel comfortable recommending them to the Physician Wellness Program.
Definitely Yes
Probably Yes
Maybe
Probably Not
Definitely Not
6. How easy was it for you to find a therapist from our program that could address your needs and schedule with you in a timely manner and in a convenient location?
Very Easy
Somewhat Easy
Somewhat Difficutl
Very Difficult
7. How many therapy sessions did you utilize during this benefit period?
Please Select
1
2
3
4
8. Therapists' Name
Please Select
Gillian DeFoe, MD
TEST ONLY
9. Any other comments or suggestions that you would like to share?
10. Would you be willing to be quoted, by name or anonymously by specialty, what the program has meant to you?
Yes, I would like to be quoted.
No, I would not like to be quoted.
How would you like to be quoted?
Anonymously
By Name
Specialty
Please provide anonymous quote below.
Name
Please provide quote below.
Please verify that you are human
*
Submit
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