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1. I participated in:

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2. Please enter the name of your counselor:

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3. The Intake Process was easy for me to complete.

  Strongly Agree Agree Disagree Strongly Disagree
Please Check One:

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4. I found the video counseling services easy to use.

  Strongly Agree Agree Disagree Strongly Disagree
Please Check One:

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5. I was comfortable engaging in counseling by video.

  Strongly Agree Agree Disagree Strongly Disagree
Please Check One:

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6. My counselor listened to the reasons I sought counseling and, based on my input, we decided the goals for treatment together.

  Strongly Agree Agree Disagree Strongly Disagree
Please Check One:

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7. As a result of counseling, I am better able to manage my life.

  Strongly Agree Agree Disagree Strongly Disagree
Please Check One:

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8. I am satisfied with the services I have received.

  Strongly Agree Agree Disagree Strongly Disagree
Please Check One:

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9. Comment Section:

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