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* 1. After reaching out to LifeWorks to inquire about therapy, I heard back within one business day.

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* 2. Please rate your level of agreement to each of the following prompts:

  Strongly disagree Disagree Neutral Agree Strongly agree
I found the intake staff helpful and informative.
It was easy to set up an initial appointment.
I got my questions answered (about the therapist, about the process of therapy, about my insurance, about my fees).
The waiting room and therapy room are pleasant and conducive to therapy.
LifeWorks' website was informative and easy to navigate.
I was matched with a therapist who met my therapy needs.
My therapist's approach and style are a good fit for me.
(If in network with BCBS PPO) I am satisfied with the insurance billing process and staff.
(If not using insurance) I am satisfied with the process of getting a superbill or statement to submit to my own insurance plan.

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* 3. Please rate your overall experience at LifeWorks so far:

0 Neutral 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 4. I would recommend LifeWorks to others:

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* 5. Additional comments or suggestions:

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* 6. If you would like to be contacted about either a compliment or a concern, please give your name and contact information here:

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* 7. If you have completed therapy at LifeWorks, please indicate the number of sessions you completed:

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* 8. My therapist's name (optional)

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* 9. Please indicate your level of satisfaction for each of the following questions:

  Strongly disagree Disagree Neutral Agree Strongly agree
I felt my therapist addressed and understood my concerns.
I saw improvement on the issues that I came in to work on.
I felt supported by my therapist.
I was able to keep the same day and time for my appointment.
I ended therapy feeling good about my work.

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* 10. May we contact you if we have further questions?  If yes, please indicate your name, preferred contact number or email address below.  Thank you. 

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