Counseling Feedback Survey
Thank you for choosing WellSpring for your counseling experience.  Your feedback on your counseling experience is helpful for us in making counseling more effective and helpful to future clients.  Your answers are confidential.  Thank you!

Read each statement carefully and indicate the level to which you agree or disagree according to the following guidelines:

1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree

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Choose what service WellSpring Counseling provided to you (more than one service can be selected) *
Required
1.  My initial contact with WellSpring was responded to promptly and professionally. *
Disagree
Agree
2.   Wellspring contacted me and set up an appt in a timely manner. *
Disagree
Agree
3.  My counselor was professional and respectful towards me. *
Disagree
Agree
4.  It was easy to connect with my counselor. *
Disagree
Agree
5.  My counselor listened to me and worked on the issues of importance to me. *
Disagree
Agree
6.  My counselor helped me to develop strategies for managing my concerns. *
Disagree
Agree
7.  My counselor provided some biblical or spiritual understanding to my issues. *
Disagree
Agree
8.  I was given adequate referrals for some of my other needs, if applicable. *
Disagree
Agree
9.  I was satisfied with the progress/completion of counseling. *
Disagree
Agree
10.  I would refer someone to WellSpring for counseling. *
Disagree
Agree
Optional:  Name of Counselor
Additional Comments
(We occasionally use anonymous quotes in our communication materials.  Please let us know if you do not want your comments considered.)
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