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  1. Surveys
  2. 2011
  3. December
  4. C
  5. Client Satisfaction

Client Satisfaction

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Hello:

You are invited to participate in our survey about client satisfaction. In this survey, you will be asked to complete a survey that asks questions about your experience with us. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. However, it is very important for us to learn your opinions. There are no foreseeable risks associated with this project. If you feel uncomfortable answering any questions, you can withdraw from the survey at any point.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Kevin Rhinehart by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
Who do you consider to be your primary therapist? Select one.
 
Cathie Wick
 
Joyce Yeager
 
Kevin Rhinehart
 
Terri Theriot
 
Terry Pape
 
Wendi McCutchen
 
 
 
Approximately how many sessions have you attended with your primary therapist?
 
 
 
What types services have you received from your primary therapist?
 
Evaluation
 
Individual Therapy
 
Couple's Therapy
 
Family Therapy
 
Group Therapy

 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied Unknown
Expertise of the therapist?
Therapist's willingness to listen
Level of therapist's care about you and your situation
Your input in determining treatment goals
Therapist's help in meeting your treatment goals
 
 
 
What comments (positive or negative) would you like to make about your therapist. Positive comments may get used on our website or other promotional material with your identity concealed.
   
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Front office friendliness
Front office helpfulness
 
 
 
Comments/Suggestions regarding the front office:
   
 
 
How satisfied are you with the following:
Very Uncomfortable Uncomfortable Neutral Comfortable Very Comfortable Not applicable
How comfortable would you feel about referring someone to us?
 
 
 
If you answered anything but Very Comfortable, please tell us what we need to do better?
   
 
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