Client Satisfaction Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please take a few minutes to complete a brief survey about your experience with Stone Counseling & Consulting Services, LLC. Your feedback helps the us to continue improving and providing the best possible service to you and other clients.

The survey is completely voluntary and your choice to participate or not participate will not affect your ability to access services. The information you provide will be anonymous and confidential. All questions are optional.

Please complete the survey to your comfort level and click "Submit" when you're finished.

We appreciate your feedback and thank you for taking time to help us better serve you!

Please rate your level of agreement with the following regarding the ADMINISTRATIVE PROCESSES:

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Disagree (2)

Strongly Disagree (1)

I understood the electronic forms I completed prior to my appointment.

The secure Client Portal feature (used for paperwork, secure messaging, appointment requests) is a valuable resource to me.

I was able to see a counselor soon enough to meet my needs.

The billing and payment process is easy.

Clear selection

Who was your primary counselor you saw? (The counselor you saw on a regular basis.)

What was your primary reason for working with this therapist?

Please rate your level of agreement with the following statements regarding your THERAPIST/THERAPY EXPERIENCE:

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Strongly Disagree (2)

Disagree (1)

Not Applicable

My counselor was sensitive to individual differences (ethnic, cultural, religious, LGBTQ, etc.).

My counselor was compassionate and understanding.

My counselor was attentive to my needs.

My counselor was knowledgeable and skilled.

My counselor's approach to counseling meets my needs.

I felt that my counselor had a good understanding of me, my concerns, and what I needed.

I felt I could share my thoughts and feelings freely with my counselor.

I am satisfied with the relationship my counselor and I developed.

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Strongly Disagree (2)

Disagree (1)

Not Applicable

My counselor was sensitive to individual differences (ethnic, cultural, religious, LGBTQ, etc.).

My counselor was compassionate and understanding.

My counselor was attentive to my needs.

My counselor was knowledgeable and skilled.

My counselor's approach to counseling meets my needs.

I felt that my counselor had a good understanding of me, my concerns, and what I needed.

I felt I could share my thoughts and feelings freely with my counselor.

I am satisfied with the relationship my counselor and I developed.

Clear selection

Please rate your level of agreement with the following regarding your COUNSELING EXPERIENCE:

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Disagree (3)

Strongly Disagree (1)

Not Applicable

Counseling gave me a safe place to express my thoughts and concerns without judgement.

Counseling helped decrease my stress levels.

Counseling improved my resilience, or my ability to cope with or "bounce back" from difficult life events or situations.

Counseling helped me improve my overall wellness.

Counseling has helped me find more joy in life.

Counseling has helped me achieve my therapeutic and/or personal goals.

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Disagree (3)

Strongly Disagree (1)

Not Applicable

Counseling gave me a safe place to express my thoughts and concerns without judgement.

Counseling helped decrease my stress levels.

Counseling improved my resilience, or my ability to cope with or "bounce back" from difficult life events or situations.

Counseling helped me improve my overall wellness.

Counseling has helped me find more joy in life.

Counseling has helped me achieve my therapeutic and/or personal goals.

Clear selection

Please rate your level of agreement with the following statements. BECAUSE OF COUNSELING:

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Disagree (2)

Strongly Disagree (1)

Not Applicable

I feel better.

I was able to resolve the concerns that brought me to counseling.

I developed coping skills that will help me in the future (stress management, emotional regulation, etc.).

I am better able to continue to working through the concerns that brought me to counseling on my own or through other methods.

I know that I can handle difficult life situations.

I am more self-aware.

Strongly Agree (5)

Agree (4)

Neutral or Undecided (3)

Disagree (2)

Strongly Disagree (1)

Not Applicable

I feel better.

I was able to resolve the concerns that brought me to counseling.

I developed coping skills that will help me in the future (stress management, emotional regulation, etc.).

I am better able to continue to working through the concerns that brought me to counseling on my own or through other methods.

I know that I can handle difficult life situations.

I am more self-aware.

Clear selection

Approximately how many sessions have you attended?

If you have ended therapy with your therapist before you intended, what led you to discontinue? (Check all that apply.)

Not applicable; I'm still attending sessions.

Counseling helped me resolve my concerns enough so that I can handle them on my own.

I felt I had enough other healthy, available people in my life who can help support me.

Life or scheduling needs changed requiring me to discontinue/take a break from counseling.

I felt I needed a specialty treatment method.

I wanted to seek alternate treatment methods, such as hypnosis, life coaching, etc.

I did not find counseling to be helpful.

I did not feel connected to my counselor.

Other:

What is your gender?

What is your race/ethnicity? (Check all that apply.)

American Indian or Alaskan Native

Asian

Black or African American

Hawaiian Native or Pacific Islander

Hispanic or Latino(a)

White or Caucasian

Multiracial

Prefer not to disclose

Is there anything you feel we did exceptionally well?

What suggestions do you have for improvements?

[Optional] If you feel comfortable, please provide a testimonial describing your positive experience. NOTE: By providing your testimonial, you understand and agree that your testimonial may be used/shared for marketing purposes (e.g., website, advertisements, destigmatizing campaigns) without additional consent. Any identifying information will be removed prior to use.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Stone Counseling & Consulting Services, LLC. Report Abuse

Forms