Give Us Your Feedback
Hi!  We would love to hear your thoughts or feedback on how we can improve your overall experience with Traveling Light Counseling. Your comments will not be shared outside of Traveling Light Counseling and will not be posted online or elsewhere. We will use the data to improve areas of need with therapists and admin.

*Questions are adapted from Scott Miller's Session Rating Scale.
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Email *
Your Name
Your Therapist's Name *
This helps us provide feedback and support to TLC's clinicians. If you see multiple therapists, we'd benefit from having this filled out once for each therapist.
Please rate your sessions with your clinician.  
If you work with multiple clinicians, please fill this out for one therapist at a time. Thank you!

Your relationship with your clinician *
I do/did not feel heard, understood and respected.
I feel/felt heard, understood and respected.
Goals and topics in your sessions *
We do/did not work on or talk about what I wanted to work on and talk about.
We work/worked on and talk/talked about what I wanted to work on and talk about.
Your therapist's approach or method *
The therapist's approach is/was not a good fit for me.
The therapist's approach is/was a good fit for me.
Overall *
Overall there's something missing in the sessions.
Overall our sessions are right for me.
How you are feeling
Looking back over your sessions, help us understand how you have been feeling by rating how well you have been doing in the following areas of your life, where marks to the left represent low levels and marks to the right indicate high levels. If you are filling out this form for another person, please fill out according to how you think he or she is doing.
Individually (personal well-being) *
Interpersonally (family, close relationships) *
Socially (work, school, friendships) *
Overall (general sense of well-being) *
How likely is it that you would recommend Traveling Light Counseling to a friend or colleague? *
Not Likely
Very Likely
Your experience with administrative staff
Please let us know your experience with scheduling and billing areas.

How was your experience with scheduling an appointment at Traveling Light Counseling? *
It was difficult to get in touch with and schedule an appointment with a therapist.
It was easy to get in touch with and schedule an appointment with a therapist.
If below a 10, please let us know how we can improve.  
How is/was your experience with our billing department?
I did not have a good experience with the billing department.
I have/had a good experience with the billing department.
Clear selection
Is there anything else you would like to let us know.   *
Review: *
THANK YOU!
I sincerely appreciate your feedback and take every response seriously and use the information to improve clients' experience at Traveling Light Counseling. Thanks again!
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