Client Survey
The following survey distributed by The Place Within Counseling Center, Folsom is designed to collect information regarding your satisfaction with our services. The survey is completely voluntary and anonymous; your name will NOT be associated with your responses. Please complete the quick 5 minute survey and respond as honestly as possible to help us improve our services. Thank you and have a great day.
What was your therapist's name? (If remembered)
Your answer
When did you begin therapy at our center?
MM
/
DD
/
YYYY
How often did you attend therapy sessions?
What date did you end therapy at our center?
MM
/
DD
/
YYYY
How quickly was your phone call returned?
Very slow (a couple of weeks)
Very fast (within a day or two)
Were you satisfied with your overall therapy experience?
Based on your answer to the previous question, elaborate on your level of satisfaction. What was most helpful? What was least helpful? Were your therapeutic goals met?
Your answer
What feedback or suggestions do you have?
Your answer
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