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* 1. Date of Assessment

Date

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* 2. The Epworth Center for Counseling responded to my referral/need for an appointment in a timely manner.

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* 3. The initial Intake packet was easy to complete.

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* 4. I was satisfied with the knowledge and information provided during the Intake process.

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* 5. The facility was clean and well-maintained.

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* 6. The waiting area was comfortable and inviting.

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* 7. I was greeted by staff in a friendly and timely manner.

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* 8. My counselor saw me at my scheduled appointment time.

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* 9. My counselor was prepared for my session.

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* 10. My counselor paid attention to what I had to say.

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* 11. My counselor understood my concerns.

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* 12. My counselor focused on achieving the goals of my treatment plan with me.

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* 13. I was satisfied with my experience at Epworth Center for Counseling.

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* 14. Based on my experiences at Epworth Center for Counseling, I would refer a friend or family member.

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* 15. How did you hear about us?

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* 16. In what ways we can improve our services?

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* 17. Any other comments/concerns?

0 of 17 answered
 

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