Client Satisfaction Survey
Thank you for choosing to visit us at Wake Counseling & Mediation. We appreciate you taking the time to share your feedback regarding your experience with us. Please feel free to be open and honest, as your responses will assist us with both recognizing excellence and ensuring quality care for all of our clients.
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Email *
Your Name *
What is the name of your therapist? *
Please rate your overall experience. *
Excellent
Very Poor
Please rate the experience that you had with requesting services and getting scheduled *
Excellent
Very Poor
How would you rate your experiences with the front office staff? *
Excellent
Very Poor
Does telehealth make it easier to obtain the care that you need? *
Which do you prefer? *
Does/did your therapist listen to what you were trying to get across? *
Not at all
Definitely
Does/did your therapist present in a professional manner? *
Not at all
Definitely
Does/did your therapist seem to understand what you are/were thinking and feeling? *
Not at all
Definitely
Do/did you have a clear idea of the goals that you and your therapist are/were trying to achieve? *
Not at all
Definitely
Do/did you feel like your therapist is/was a good fit for your needs? *
Not at all
Definitely
How comfortable and inviting is/was the office? *
Very Poor
Excellent
Based on your experience, how likely are you to recommend Wake Counseling & Mediation to a friend? *
Not at all
Definitely
Is there anything else you would like us to know about your experience with Wake Counseling & Mediation? *
Would you like someone to contact you regarding your responses? *
Best way to contact you: *
Required
What is your email address and/or phone number? *
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