Existing Client Satisfaction Form

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Thank you for entrusting us with your emotional and mental wellness here at Inner Coach Counseling, LLC.

We want to hear from you because we value your feedback. The information that you provide will help us measure how well we are doing and if we need improvement in our service delivery to the community.

Email *

Overall, how pleased are you with your service and support at Inner Coach Counseling, LLC? *

Not at all

Extremely Pleased

If you are interested in group work (support groups or group therapy) what problem would you want to focus on? *

Managing Grief

Coping with Heartbreak

Dating and Relationship

Coping with Work Stress

Racism and Microaggressions

Coping with Sexual Transmitted Disease (s)

Overcoming People Pleasing

No Suggestions

Other:

Please provide helpful feedback about any of the services listed above.

What supports would you like to receive that you currently do not receive?

Is there something specific that your therapist does that has been most helpful or effective? If so please describe? *

How confident are you in your therapist's ability? *

Not At All

Extremely

Would you recommend Inner Coach Counseling, LLC to a friend or family member? *

Yes

Other:

Would you recommend your therapist to a friend or family member? *

Yes

Other:

If you were to recommend us, what would you say to describe your experience? *

What would help make your therapy experience better? (include communication, scheduling, insurance billing concerns, pricing, hours, etc) *

What is your therapist name? *

Maxine Carelock

Valencia Beard

Tamika Stewart

Gena Golden

Other:

TESTIMONY- LOVE LETTER

If you've ever written or received a love letter you know how special they are. Love letters are filled with warmth and gratitude; inspiring the receiver to keep doing what works.

Everyone wants a love letter and we are no exception!

We would be honored if you could write a brief description of your positive experiences about how you were helped or supported (both big and small ways).

Why? Because we want to know if what we are doing is working.

For this reason, your testimony is super important to us and to potential consumers/clients -- showing us ways to improve and inspiring us to do good work in the world.

By volunteering to offer a testimony, you agree to give us permission to use your 'love letter' on our website or other marketing materials/platforms; however we will protect your identity if requested.

Please indicate how you would like your name signed after your testimony (ie, Last name and First initial, or your First name and Last initial, or Initials only, or Anonymous. Also include city and/or state).

We truly appreciate your testimony ~ Love Letter!

{This is a judgement-free and pressure-free zone, so If you wish to not do so, please indicate below.}

We appreciate your feedback! Remember that this information is anonymous and will only serve to help us to be more effective. Thank you!

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