Session Feedback Survey

Therapy Session Feedback Survey

Please provide your feedback about your recent therapy session.
Name

First NameLast Name
Date of Session

MonthDayYear
Date
Overall Satisfaction*

1

2

3

4

5

1 is , 5 is Best
How comfortable did you feel during the session?*

1

2

3

4

5

1 is , 5 is Best
Were your concerns addressed adequately?*

YesNoPartially
What did you find most helpful about the session?
What could be improved in future sessions?
Additional Comments
Should be Empty:

Therapy Session Feedback Survey