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JEANETTE KRAEMER CLIENT FEEDBACK
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Your Name: (optional)
Your answer
Date of your appointment: (optional)
MM
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I felt respected, heard, and understood by my provider
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Not ideal
1
2
3
4
5
Matched my expectations
We talked about and worked on what I wanted to talk about this session.
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Not ideal
1
2
3
4
5
Met my expectations
This provider's approach feels like a good fit for me.
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Not ideal
1
2
3
4
5
Met my expectations
Overall, my appointment met my expectations/felt right.
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Not ideal
1
2
3
4
5
Met my expectations
I was able to get a follow-up appointment that met my needs.
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Not ideal
1
2
3
4
5
Met my needs/expectations
I will continue care with Jeanette.
*
Yes
No
Maybe
If answered No or Maybe above, feel free to share more information about your experience.
Your answer
If this applies: who would you like to reach out to you for any transfer or rescheduling help?
One of our intake coordinators
I plan to look elsewhere
Clear selection
Feel free to share any additional information/feedback.
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