Thank you for providing us with valuable feedback!

Please complete this survey to provide valuable feedback for your therapist, Lisa Johnson, on how helpful the therapy process has been for you. If you are continuing in therapy with Lisa, you may want to discuss your responses at your next session. If you have chosen to discontinue therapy with Lisa Johnson, the information provided can be a useful way to communicate what has been helpful for you, or not, and why you have chosen to discontinue therapy at this time.

1. Please rate the degree to which therapy has been helpful for you, in terms of getting help on what you wanted help with.

2. Please rate how much benefit you believe the therapy process has had for you in terms of helping you to get a better picture of your situation and the choices that you have.

3. Please rate the extent that the therapy process has helped you to learn and/or practice new behaviors, such as coping skills, or learning new ways of interacting with others.

4. Please rate the degree to which you felt comfortable in sharing personal, confidential information with Lisa Johnson.

5. Please rate your perception of how much of an interest Lisa Johnson took in your situation.

6. Please rate, overall, how you felt about the therapy process with Lisa Johnson.

7. Please rate whether you would want to see Lisa Johnson again in the future.

8. Would you accept a referral from Lisa Johnson to another Therapist (as compared to would you want to find another Therapist without the involvement of your current Therapist?)

9. Please rate how likely you would be to see a Therapist in the future.

10. Please rate how confident you are now in dealing with life's issues and challenges.

11. Would you give permission for the comments in this evaluation to be used for marketing purposes?

100% of survey complete.