Northlight Counseling Client Satisfaction Survey
This is an optional and anonymous survey to gather information on client retention factors.
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1. I am a current or former client at  Northlight Counseling
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2. So far, I have participated in therapy at Northlight Counseling for:
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3. I was informed of my rights:
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4. I felt safe, attended to, and cared for while I was here.
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5. The environment was clean and comfortable.
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6. Staff were sensitive to my language, cultural, and spiritual needs.
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7. I had input into my treatment goals.
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8. I felt comfortable with my provider.
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Name of provider *
9. I was treated with dignity and respect.
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10. I feel better now than when I started services.
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11. Overall I was very satisfied with the services I received.
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12. I would recommend this facility to someone needing services.
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13. Location where you received services
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Additional Feedback:
Would you like to be contacted by one of our Clinical Directors about your feedback? If so, please leave your email or phone number. 
Would you like to be removed from our mailing list?
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Thank you so much for taking the time to complete this form! We appreciate it!
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