Clay Counseling Feedback Survey
Please let us know how we did today! Responses will remain anonymous.
Sign in to Google to save your progress. Learn more
How satisfied were you with our services? *
Very Unsatisfied
Very Satisfied
How relevant and helpful was your appointment? *
Very Unsatisfied
Very Satisfied
How likely are you to continue working with us? *
Very Unlikely
Very Likely
Was there a long wait to be seen/helped? *
What made your time here satisfying or unsatisfying? *
What is one thing that we can improve on? *
What would you tell your friends/colleagues about us? *
Additional Comments? (Optional)
Clear form
Never submit passwords through Google Forms.
This form was created inside of Clay Counseling Solutions, Inc.. Report Abuse