1. Completing this questionnaire will help us continue to provide high quality services.

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* 1. Demographics

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* 2. Ease of getting care

  Excellent Good Fair Poor N/A
Ability to get in to be seen
Prompt return of phone calls
The staff at LPA handles client matters in a professional and respectful manner
The staff at LPA attempt to be helpful and effective with questions or problems

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* 3. Treatment Outcomes

  Strongly Agree Agree Neutral Disagree Strongly Disagree
I felt supported and encouraged by my therapist
My therapist understands my concerns and feelings
Skills that I learned in therapy are helping me make positive changes in my life
In our sessions we were covering what is important to me
I am making a lot of progress on reaching my goals
Therapy is improving my quality of life
Overall, therapy has been helpful
I would recommend LPA to others who are seeking counseling services

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* 4. During this episode of treatment, I have attended therapy and/or medication management at Lansing Psychological Associates:

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* 5. How much did the following problems bother you in the past week?

  Not at All A Little Somewhat A Lot
Nervousness or shakiness
Feeling sad or blue
Feeling hopeless about the future
Feeling everything is an effort
Feeling no interest in things
Your heart pounding or racing
Trouble sleeping
Feeling fearful or afraid
Difficulty at home
Difficulty socially
Difficulty at work or school

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* 6. How much do you agree with the following?

  Strongly Agree Agree Disagree Strongly Disagree
I feel good about myself
I can deal with my problems
I am able to accomplish the things I want
I have friends or family that I can count on for help

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