Satisfaction Survey
Please rate the following statements regarding your experience with Brooke Randolph, LMHC. No questions are required on this form, so answer as many or as few based on what fits for you. Thank you for your feedback and your trust in me.
I have a greater understanding of the problems that originally brought me to counseling
not at all true
very true
Clear selection
The problems that originally brought me to counseling have improved
not at all true
very true
Clear selection
I have achieved the goals that I set at the beginning of counseling
not at all true
very true
Clear selection
I feel comfortable in the office space:
not at all true
very true
Clear selection
I believe the office space protects my privacy/confidentiality:
not at all true
very true
Clear selection
I believe my counselor/coach protects the confidentiality of my personal information and file:
not at all true
very true
Clear selection
I feel a positive rapport with my counselor:
not at all true
very true
Clear selection
I feel heard, understood, and respected by my counselor:
not at all true
very true
Clear selection
I have been able to work on and talk about what I wanted:
not at all true
very true
Clear selection
The approach is a good fit for me:
not at all true
very true
Clear selection
My counselor is able to communicate with me effectively:
not at all true
very true
Clear selection
My counselor is open to discussing my concerns regarding this process:
not at all true
very true
Clear selection
I would recommend my counselor to others:
not at all true
very true
Clear selection
What did you most appreciate about working with Brooke?
What would you say to someone else considering working with Brooke?
Is there any other feedback you would like to provide?
Have you completed this survey previously?
Clear selection
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