Please help me identify which areas I'm serving you well and areas in which I can serve you better.

Please be as descriptive as possible. Any and all information will help me help you!

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* 1. In one sentence describe yourself. e.g. I am a 34 year old SLP and mom of two with a passion for helping adults with aphasia

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* 2. Where exactly did you first hear about The Independent Clinician?

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* 3. Where are you in the process of treating private clients?

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* 4. How likely is it that you would recommend The Independent Clinician to a friend or colleague?

Not at all likely
Extremely likely

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* 5. If you've purchased any products from The Independent Clinician, what helped you make the decision to purchase?

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* 6. If you haven't purchased any products from The Independent Clinician, what has stopped you?

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* 7. What is the greatest obstacle standing in the way of your having your ideal private practice?

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* 8. What is (at least) one area of private practice that you wish you had more information about?

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* 9. What does your dream private practice "look like"?

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* 10. Fill in the blank: Having a successful private practice would allow me to _________________________.

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