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Hinman Counseling Client Satisfaction Survey

Disclaimer: Participation is voluntary, and response will be kept anonymous to the degree permitted by the technology being used. Participation or nonparticipation will not impact  your relationship with your mental health provider. We sometimes use comments (from this survey) to publicize our services.  All quotes are kept anonymous. Submission of the survey will be interpreted as your informed consent to participate and that you affirm that you are at least 18 years of age. 

Directions: For each question, place select the answer that best describes your experience. Please indicate the answer that most applies to you.
1.Name of Counselor
2.How long have you been meeting with your counselor?
3.How often do you meet with your counselor?
4.What is your overall satisfaction with your counselor?
5.How well has your counselor helped you achieve the purpose for which you sought or are continuing counseling?
6.How well has your counselor shown interest and understand your needs?
7.How well has your counselor acted professionally and maintained privacy and confidentiality?
8.How helpful has the administrative staff been when you have had questions or concerns?
9.How did you hear about us?
10.Additional comments and suggestions about our services or other services you like to see us offer in the future: