Client Satisfaction Survey

* 1. Overall, how easy do you find it to schedule appointments?

Extremely easy

Quite easy

Moderately easy

Slightly easy

Not at all easy

* 2. How likely are you to use our service again in the future?

Extremely likely

Quite likely

Moderately likely

Slightly likely

Not at all likely

* 3. Do you have any other comments, questions, or concerns?

* 4. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

* 5. Do you have any other comments, questions, or concerns?

* 6. What changes would most improve your experience with IMH?

* 7. Overall, are you satisfied with your experience using therapy at IMH, dissatisfied with it, or neither satisfied or dissatisfied with it?

Extremely satisfied

Quite satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Quite dissatisfied

Extremely dissatisfied

* 8. What would make you more likely to use therapy services in the future?

* 9. How well do you feel our company protects your privacy?

Extremely well

Quite well

Moderately well

Slightly well

Not at all well