Presby Psych is committed to providing the highest quality mental health services.  Your feedback is important to us in meeting that goal.  We very much appreciate your willingness to take the time to complete this survey.  Your responses are anonymous.
Clients 15 years old or older may respond to this survey themselves
The parents/guardians of clients 0-14 years old may respond to this survey on behalf of the child.  We urge you to consult your child on the answers.

* 1. Your/Your Child's Therapist's Name:

* 2. How old are you or your minor child? 

* 3. How long have you or your minor child been seeing this therapist?

* 4.  I feel my therapist understands me and my experiences / My child and I feel the therapist understands my child and his/her experiences

* 5. I feel that my therapist collaborates with me regarding my therapy / My child and I feel that his/her therapist collaborates with me and my child about his/her therapy

* 6. I feel helped by my therapist / My child & I feel s/he is being helped by the therapist

* 7. My therapist is sensitive to my racial and cultural identity / My child's therapist is sensitive to our racial and cultural identity

* 8. I feel that I can talk to my therapist about disagreements, frustrations, or concerns I have with him/her or the therapy / I feel my child and I can talk to his/her therapist about disagreements, frustrations, or concerns s/he or I have with the therapist or the therapy

* 9. I feel that my therapist is knowledgeable about the issues we talk about in therapy / My child and I feel that the therapist is knowledgeable about the issues addressed in the therapy

* 10. I trust my therapist / My child and I trust his/her therapist

* 11. Overall, I am satisfied with the clinical care provided by my therapist / Overall, my child and I are satisfied with the clinical care provided by my child's therapist

* 12. Please add any comments you would like to share about your therapist / your child's therapist

* 13. The Presby Psych receptionist is respectful and professional

* 14. Making a first appointment with Presby Psych was a satisfactory experience

* 15. The initial Client Information paperwork  at Presby Psych is reasonable

* 16. My questions about cancellation policies and other clinical policies are answered promptly and respectfully

* 17. The billing staff at Presby Psych is respectful and professional

* 18. I am satisfied with the financial statements I receive

* 19. My financial questions are answered accurately and respectfully

* 20. Please add any comments you would like to share about our receptionist, paperwork, and/or billing staff 

* 21. Would you recommend Presby Psych to a friend or relative?

Thank you for completing this survey. 
Presbyterian Psychological Services
5203 Sharon Road
Charlotte, NC 28210
(704) 554-9900
www.presbypsych.org

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