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Client Satisfaction Survey
1.
I feel understood and respected by my psychologist.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
2.
My psychologist listens attentively and without judgement.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
3.
I feel emotionally safe during my sessions.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
4.
I feel my psychologist possesses the necessary knowledge and skills to address my concerns.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
5.
I am confident my psychologist understands my issues.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
6.
My psychologist has the ability to handle challenging or complex aspects of my presenting issues
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Other (please specify)
7.
My psychologist explains things in a way that make sense to me.
Always
Usually
Sometimes
Rarely
Never
8.
My sessions are helping me reach my treatment goals.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
9.
I feel involved in decisions about my treatment.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
10.
The strategies and tools used in sessions are helpful.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
11.
I have noticed positive changes in myself as a result of therapy.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
12.
I would recommend my psychologist to others
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
13.
I am able to talk about what is important to me.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Other (please specify)
14.
What has been most helpful for you in therapy?
15.
What would you like to see done differently?
16.
Other comments
17.
If you'd like to leave your name (optional), please enter below
18.
Would you like follow-up
No
Yes
19.
How would you rate your experience with JMB Psychology?
1 star
2 stars
3 stars
4 stars
5 stars