Question Title

* 1. What is your field of work?(More than one Answer can be chosen)

Question Title

* 2. Why did you refer to this Licensed Mental Health Counselor?(Check all that apply)

Question Title

* 3. Are you aware of any of these ways to read/receive information about this Licensed Mental Health Counselor?

Question Title

* 4. Which of these ways is the preferred way of receiving information

Question Title

* 5. What services/products do you know that this Licensed Mental Health Counselor uses in his practice? (Check all that apply)

Question Title

* 6. If this Licensed Mental Health Counselor offered a co-lead support, psycho-educational group that focusses on depression/anxiety/stressors, would you refer? (This co-lead online group would be not covered by insurance)

Question Title

* 7. Would you consider referring to this group as an alternative for clients who may be seeking individual counseling at this time but that you cannot accommodate in your practice right now?

Question Title

* 8. If you want to be included in the drawing for a prize(Chocolate, coffee, Gift card), please write your email. (You do not have to leave your email)

T