Client Satisfaction Questionnaire
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1. Default Section

100%

1. Therapist's Name

Therapist's Name Laura Asbell, PhD

Wendy A. Biondi, LMHC

Mark J. Baird, PsyD

2. How would you rate the quality of care you have received from our practice?

	Excellent	Good	Fair	Poor
Rating	How would you rate the quality of care you have received from our practice? Rating Excellent	Rating Good	Rating Fair	Rating Poor

3. Are your therapy sessions helpful in dealing with your problems?

	No, definitely	No, not really	Yes, generally	Yes, definitely
Rating	Are your therapy sessions helpful in dealing with your problems? Rating No, definitely	Rating No, not really	Rating Yes, generally	Rating Yes, definitely

4. Did you feel heard and understood by your therapist?

	No, definitely	No, not really	Yes, generally	Yes, definitely
Rating	Did you feel heard and understood by your therapist? Rating No, definitely	Rating No, not really	Rating Yes, generally	Rating Yes, definitely

5. Did you feel respected and valued by your therapist?

	Yes, definitely	Yes, generally	No, not really	No, definitely not
Rating	Did you feel respected and valued by your therapist? Rating Yes, definitely	Rating Yes, generally	Rating No, not really	Rating No, definitely not

6. How would you rate the helpfulness and courtesy of our office manager?

	Excellent	Good	Fair	Poor
Rating	How would you rate the helpfulness and courtesy of our office manager? Rating Excellent	Rating Good	Rating Fair	Rating Poor

7. If a friend were in need of similar help, would you recommend our practice to him or her?

	Yes, definitely	Yes, I think so	No, I don't think so	No, definitely not
Rating	If a friend were in need of similar help, would you recommend our practice to him or her? Rating Yes, definitely	Rating Yes, I think so	Rating No, I don't think so	Rating No, definitely not

8. Overall, how satisfied are you with your therapist and our practice?

	Quite dissatisfied	Mildly dissatisfied	Mostly satisfied	Very satisfied
Rating	Overall, how satisfied are you with your therapist and our practice? Rating Quite dissatisfied	Rating Mildly dissatisfied	Rating Mostly satisfied	Rating Very satisfied

9. If you were to seek help again, would you come back to our practice?

	No, definitely not	No, I don't think so	Yes, I think so	Yes, definitely
Rating	If you were to seek help again, would you come back to our practice? Rating No, definitely not	Rating No, I don't think so	Rating Yes, I think so	Rating Yes, definitely

10. How might we improve to serve your needs better?

How might we improve to serve your needs better?

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