Avenues Satisfaction Survey
Please answer these 12 short questions to help assist us in making your experience the best we can.
First Name Only (Optional)
Therapist/Doctor's Name *
1. How would you describe your first interaction with a staff member of Avenues of Counseling and Mediation, LLC?
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2. How long was the wait between your first call and first visit?
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3. How convenient is the location of the private practice for you?
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4. How would you describe your feelings on the overall appearance and comfort of the office?
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5. How would you describe your feelings on the help you receive at the check-in window?
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6. How do you feel about the help you receive when you call the office?
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7. How would you describe your feelings towards the first meeting with your Clinician?
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8. Do/did you feel your Clinician understands your issue(s)?
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9. Do/did you feel confident in your Clinician's ability to be able to treat you or your family member?
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How many sessions have you had with your clinician?
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11. Would you recommend your Clinician to a friend?
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12. Would you recommend Avenues of Counseling and Mediation, LLC to a friend?
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Comments to explain any of the above:
Can we post your comments anonymously on our website under reviews?
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Would you like the Owner to contact you regarding your experience at Avenues? (If yes, please give the receptionist your name and phone number.)
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PLEASE INQUIRE WITH THE FRONT DESK IF YOU WOULD LIKE TO TAKE AN ADDITIONAL SURVEY REGARDING ANOTHER CLINICIAN.
I sincerely appreciate your time in completing the Survey. Your assistance will help Avenues maintain a high quality of care for everyone. Lisa M. Borchert-Hrivnak, MAEd, LPCC, Owner.
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