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Client Satisfaction Survey
Synergy Counseling Center strives to continuously improve our services. Your anonymous feedback is very much appreciated.
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* Required
Q1
*
I felt accepted by my therapist:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q2
*
I believe my therapist liked me:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q3
*
I felt like my therapist understood my feelings:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q4
*
My therapist was honest and sincere:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q5
*
My goals were important to my therapist:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q6
*
The sessions go smoothly and are comfortable for me:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q7
*
My sessions go deep rather than talking on the surface:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q8
*
My sessions are helpful to my life:
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q9
*
My sessions give me hope for my future:
Strongly Disagree
1
2
3
4
5
Strongly Agree
The staff was pleasant and accommodating.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
Q10
Which therapist did you see?
Dr. Don G. Brock
Dr. Jack Weaver
Mr. John Paul Ruffin
Ms. Bethany Sandlin
Intern Barry Camp
Clear selection
Q11
If you have any comments or suggestions, feel free to add them below:
Your answer
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