Client Feedback Form

Help us improve!

We need your feedback to get better (and don't worry, this is anonymous).
TEXT Therapist/Coach Name
Therapist/Coach Name
Select the answer that fits:

I never met with the therapist/coach.I had a free consult but did not move forward.I am still having sessions.I started sessions but dropped out.I started sessions, met our goals and then ended sessions.
Never met
I didn't follow up with getting help because:

Too expensiveUnable to use in-network insuranceI decided I didn't need helpI found a different provider elsewhereI had a negative experience (please share below)Other (please share below)
Free Consult - Stop
I dropped out after the free consult because:

The consult did not go wellToo expensiveUnable to use in-network insuranceI decided I didn't need helpI found a different provider elsewhereI had a negative experience (please share below)Something else (please share below)
The consult did not go well because: (select all that apply)

I did not feel heard and understoodI did not have confidence that he/she could helpWe did not have a clear plan to move forwardIt was not a good fitSomething else (please share below)
Still meeting
Please rank your therapist or coach on the following:
Feeling heard and understood
Working on the right goals
Fit of approach
Ability to help
My therapist / coach talks:

Too littleJust rightToo much
Started - dropped out
I dropped out because (select all that apply):

I did not feel heard and understoodI did not have confidence that he/she could helpI did not hear a plan to move forwardIt was not a good fitSomething else (please share below)
Had sessions - met goals
I felt heard and understood.
We worked on the right goals.
My therapist or coach's approach was a good fit.
I had confidence in my therapist or coach's ability to help me.
My therapist / coach talked:

Too littleJust rightToo much
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Help us improve!

Please rank your therapist or coach on the following: