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Counseling Experience Survey
We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. All responses will be kept confidential and anonymous. Thank you for your time!
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* Indicates required question
First and last name:
Your answer
Please select the type of service you received from us:
*
Individual Adult Therapy
Individual Child/Teen Therapy
Couples Counseling
Coaching Sessions
Family Therapy
Other:
Your first contact with the Austin Mindfulness Center (website, phone, email) was:
*
Negative
1
2
3
4
5
Positive
Your experience of getting started at Austin Mindfulness Center was:
*
It was difficult to get in touch with and schedule an appointment with a therapist.
1
2
3
4
5
It was easy to get in touch with and schedule an appointment with a therapist.
Your experience with billing at Austin Mindfulness Center has been:
Negative
1
2
3
4
5
Positive
Clear selection
Please provide us some feedback about your experience with Intake and/or Billing
Your answer
Your therapist listens to you carefully, respects you and understands your concerns:
*
Not at all
1
2
3
4
5
Completely
Your therapist shows up on time for each session:
*
Never
1
2
3
4
5
Always
Your therapist is helping you achieve the purpose for which you sought counseling:
*
Not at all
1
2
3
4
5
Absolutely
Your therapist provides you skills that will help you in the future:
*
Not at all
1
2
3
4
5
Absolutely
You and your therapist are working together towards agreed goals:
*
Not at all
1
2
3
4
5
Absolutely
The therapist and their approach to therapy:
*
Are NOT a good fit for me
1
2
3
4
5
ARE a good fit for me
Your therapist has talked about the benefits of mindfulness and has taught you mindfulness tools (meditation, breathing exercises, journaling, mindful listening, etc.)
*
Not at all
1
2
3
4
5
Absolutely
Would you like to learn even more about Mindfulness?
*
Not at all
1
2
3
4
5
Absolutely
How likely would you recommend Austin Mindfulness Center to a friend or colleague?
Not likely
1
2
3
4
5
Very likely
Clear selection
How would you rate your overall therapy experience?
*
Overall, there's something missing in the sessions
1
2
3
4
5
Overall, the sessions are right for me
Please select your therapist:
*
Dr. Kristin Vaughn
Alexandria (Ally) Bresnahan
Alicia Ang
Alphonso Miller
Amanda Bailey
Amy Nikitenko
Anna Khayatt
Benjamin Long
Brittany Tyrell
Brooke DiGiorgio
Callye Lawrence
Cassidy Conway
Dulcinea Sanchez
Elizabeth (Libby) Minger
Giselle Otamendi
Jontaye' Bonds
Karla Corro
Katina Rudley
Kelly Parker
Kristy Demers
Lyndsay Dawson
Margot Goralczyk
Marla Sanderson
Mattew Dewit
Michelle Overman
Nallely Martinez
Olivia Kropf
Rachel Lhamon
Randall (Randy) Webster
Rubi Lopez
Ryan Candito
Sarah Osterberg
Teresa Gross
Virginia Cruz
Other:
Anything else you would like us to know about your experience with us?
Your answer
Do you authorize the Austin Mindfulness Center to share your comments as an anonymous testimonial?
*
Yes, I authorize
No, I do not authorize
Would you like someone from Austin Mindfulness Center to reach out to you to address your concerns?
*
Yes, I authorize
No, I do not authorize
Thank you for your participation! If there is something we can do better, you can reach out to us anytime at
admin@austinmindfulness.org
All answers are confidential and will not be linked with your name or personal information.
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