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How satisfied are you with the therapy you have received?
 
Very satisfied
 
Mostly satisfied
 
Indifferent or mildly dissatisfied
 
Quite dissatisfied
 
Additional Comments (optional)
 
 
 
 
Do you feel your therapist has provided a safe, comfortable environment for you to talk about difficult experiences/feelings?
 
Yes, definitely
 
Yes, I think so
 
No, I don't think so
 
No, definitely not
 
Additional Comments (optional)
 
 
 
Please indicate the degree to which you found these qualities within the therapist/therapy you experienced:
Yes, very much Yes, somewhat Perhaps, not sure Definitely not
Good Judgement
Patience and Acceptance
Experience
Education
Ability to maintain confidentiality
Genuineness and Warmth
Discretion
 
 
Please indicate your level of satisfaction with each of the elements below:
Completely satisfied Mostly satisfied Needs improvement Disappointing
Telephone Calls/emails returned promptly
Appointment scheduling and availability
Friendliness and courtesy of office staff
Office location
 
 
 
Would you feel comfortable referring a friend or colleague to this therapist?
 
Yes
 
No
 
Additional Comments (optional)
 
 
 
 
If willing, please use the space below to provide a comment to be used in "client testimonials" on the website: www.tahoetreatmentcenter.com.
   
 
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