Pennsylvania Counseling Services

This survey is voluntary and all questions are optional. Feel free to skip questions and omit any information you do not want to disclose. The exclusive purpose of this survey is to provide our PCS Executive Board with feedback so we can improve our services and our clients’ experience. All information gathered from this survey falls under our standard confidentiality practices and will be kept private.

Thank you for your participation!

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* 1. PCS general information:

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* 2. Please type your contact information (OPTIONAL).

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* 3. How likely is it that you would recommend the therapist or staff member named above to a friend or colleague?

Not at all likely
Extremely likely

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* 4. How long have you been a client of PCS?

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* 5. How well do our services meet your needs?

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* 6. How likely is it that you would recommend PCS to a friend or colleague?

Not at all likely
Extremely likely

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* 7. How would you rate our staff's friendliness, courtesy and respect?

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* 8. How would you rate your therapist's ability and willingness to understand and listen to your concerns?

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* 9. Would you like us to contact you as a result of this survey?

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* 10. Please use the space below to tell us about any other comments, questions or concerns you have or changes you would like to see. You may also feel free to tell us about a specific PCS staff member you who would like to compliment or who you have concerns about.

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