Counseling Experience Survey
We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. All responses will be kept confidential and anonymous. Thank you for your time.
First and Last Name:
Please select the type of service you received from us:
Clear selection
Your first contact with the Austin Mindfulness Center (Website, Phone, Email) was positive:
Strongly Disagree
Strongly Agree
Clear selection
Your experience of Getting Started at Austin Mindfulness Center was positive:
Strongly Disagree
Strongly Agree
Clear selection
Your Therapist listens to you carefully, respects you and understands your concerns:
Not at All
Completely
Clear selection
Your Therapist shows up on time for each session
Never
Always
Clear selection
Your Therapist is helping you achieve the purpose for which you sought Counseling:
Not At all
Absolutely
Clear selection
Your Therapist provides you skills that will help you in the Future
Not At All
Absolutely
Clear selection
You and your therapist are working together towards agreed goals:
Not At All
Absolutely
Clear selection
Do you consider the Therapeutic approach to your problem is correct?
Not At All
Absolutely
Clear selection
Please select your Therapist:
Clear selection
How likely would you recommend Austin Mindfulness Center to a friend or colleague?
Not likely
Very likely
Clear selection
Anything else you would like us to know about your experience with us?
Do you authorize the Austin Mindfulness Center to share your comments as an anonymous testimonial?
Clear selection
If needed, can we contact you to follow up on your responses?
Clear selection
Thank you for your participation! If there is something we can do better, you can reach us at this email address: admin@austinmindfulness.org
All answers are confidential and will not be linked with your name or personal information.
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