Serenity-BHS Client Feedback Survey

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* 2. How long have you been a client with our company?

Less than a month

One to Three months

Three to 6 months

6 months to a year

More than a year

I haven't made a purchase yet

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* 3. Overall, how satisfied or dissatisfied are you with our company?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

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* 4. Which of the following words would you use to describe our Intake and Admin department staff?

Extremely helpful

Very helpful

Somewhat helpful

Not so helpful

Not at all helpful

N/A

Other (please specify)

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* 5. Which of the following words would you use to describe our services? Select all that apply.

Extremely helpful

Very helpful

Somewhat helpful

Not so helpful

Not at all helpful

Other (please specify)

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* 6. Do you prefer Tele-therapy or In-Person counseling sessions the best?

Tele-therapy is my current preference

In-Person counseling sessions are my preference

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* 7. How would you describe our office space and facilities?

Far above average

Above average

Average

Below average

Far below average

I've only received services via tele-therapy

Other (please specify)

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* 8. How would you rate the skills and professionalism of your therapist?

Very high quality

High quality

Neither high nor low quality

Low quality

Very low quality

Other (please specify)

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* 9. How would you rate your overall emotional and mental health at the time you first contacted us?

Very poor

Poor

Average - okay

Positive

Very positive

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* 10. How would you rate your overall emotional and mental health currently?

Much better

Better

About the same

Worse

Much worse

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

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* 12. I felt heard, understood, and respected by my therapist.

Some of the time

Yes

Some of the time

Yes

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* 13. We worked on and talked about what I wanted to work on and talk about.

Some of the time

Yes

Some of the time

Yes

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* 14. The therapist's approach is a good fit for me.

Somewhat

Yes

Somewhat

Yes

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* 15. Overall, today's session was good for me.

Somewhat

Yes

Somewhat

Yes

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* 16. Contact Information - optional

Name

Therapist Name

Date of Service

Was this a in-person session?

Serenity-BHS Client Feedback Survey - 2021

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* 1. How likely is it that you would recommend this company to a friend or colleague?

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* 2. How long have you been a client with our company?

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* 3. Overall, how satisfied or dissatisfied are you with our company?

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* 4. Which of the following words would you use to describe our Intake and Admin department staff?

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* 5. Which of the following words would you use to describe our services? Select all that apply.

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* 6. Do you prefer Tele-therapy or In-Person counseling sessions the best?

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* 7. How would you describe our office space and facilities?

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* 8. How would you rate the skills and professionalism of your therapist?

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* 9. How would you rate your overall emotional and mental health at the time you first contacted us?

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* 10. How would you rate your overall emotional and mental health currently?

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

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* 12. I felt heard, understood, and respected by my therapist.

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* 13. We worked on and talked about what I wanted to work on and talk about.

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* 14. The therapist's approach is a good fit for me.

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* 15. Overall, today's session was good for me.

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* 16. Contact Information - optional