Client Feedback Form

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Ray of Hope Child Therapy Services Inc

533 Airport Blvd. #400

Burlingame, CA 94010

877-758-7257

contact@turajohnsonmft.com

We value your feedback and always want to improve our service. We appreciate the opportunity to work with you.

Note: Answers are confidential and will not be shared with your therapist.

Which therapist did you see? *

Tura Johnson, LMFT

Coreen Beasley, LMFT

Malia Green, AMFT

Was this your first session or are you an ongoing client?

Consult

First session

Ongoing client

Clear selection

Overall, how would you rate your experience at Ray of Hope?

Clear selection

How satisfied are you with the following:

Not Satisfied

Neutra/NA

Satisfied

Scheduling

Communication

Intake experience

Clear selection

How was the experience with your therapist?

My therapist listened to me

I felt respected and not judged by my therapist

My therapist helped me explore options and solutions

My therapist started session on time

My therapist ended on time

I feel my therapist matched my needs

My therapist explained practice policies and procedures

How likely are you to:

Likely

Neutral/NA

Unlikely

Return for an appointment

Recommend your therapist to others

Recommend Ray of Hope to others

Clear selection

Would you like to leave any additional information or notes?

Would you like us to follow up about this feedback? If so, please leave your name and preferred contact method

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