Therapist Feedback Form
This will help us understand how our services have been helpful to you and what we can do better! Please note this form is anonymous, unless you choose to insert your name information at the end.
Which therapist did you work with?
Dr. Tony Martinez, LMFT
Sherrita Williams, CSW-I
Pascha Broadie, CPC-I
Rebecca Rogers, CSW-I
Lorenthia Clayton, CSW-I
Joanne Tran, CSW-I
Christie Johnson, Clinical Counseling Intern
Jordan Fuller, MSW Student
Elisia Danley, CSW-I
Alayna Hammond, CPC-I
Janelle Thompson, CSW-I
Other (please specify)
What kind of therapy did you receive?(Multiple choice)
Individual
Couples
Family
Child/Adolescent
Other
How long have you been working with this therapist?
Less than 1 month
1–3 months
4–6 months
6–12 months
Over 1 year
How would you rate your therapist’s overall support and professionalism?
1
2
3
4
5
What did you find most helpful about your sessions?
What could have been improved in your experience?
How comfortable did you feel opening up during your sessions?
Not at all comfortable
1
2
3
4
Extremely comfortable
5
1 is Not at all comfortable, 5 is Extremely comfortable
Would you recommend your therapist to others?
Yes
No
Would you like someone from our team to follow up with you?
Yes
No
Is there anything else you’d like to share?
Would you be comfortable with us sharing your feedback (anonymously) on our website or social media to help others learn about Brighter Tomorrow Therapy?(We will never use your name or identifying details.)
*
Yes
No
Name
First Name
Email address
Please verify that you are human
*
Send My Feedback
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