School-Based Community Partner Feedback Form
The Trauma-Informed Counseling Center (TICC) of Lexington endeavors to support its surrounding community by providing trauma-informed school-based services to partnering schools within Fayette County. To do our best in this endeavor, we hope that you will be generous in providing constructive feedback on our services provided in your school. While these submissions will not be received anonymously from you, we hope that you will be transparent in your feedback so that we can continue to deliver effective school-based services for Fayette County schools. We appreciate your partnership as well as your thoughtful and thorough feedback. Thank you so much. Form Completion Time: 5-10 minutes

If you have questions regarding this feedback form, you can contact TICC's Co-Director, Dr. Brittany Gentry, LCSW: bgentry@theticcoflexington.com 

If you wish to complete a PRINTED VERSION (click link to access printed version) of the Feedback Form, please download and deliver, mail, email, or fax using the following:
The Trauma-Informed Counseling Center
713 Millpond Rd. Suite B-3
Lexington, KY 40514
Phone: (859) 309-2899
Fax: (859) 368-0018
Sign in to Google to save your progress. Learn more
Email *

List the name(s) of the TICC Clinician(s) assigned to your school site: 

Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Trauma-Informed Counseling Center. Report Abuse