Client Survey

You may submit feedback anonymously if you wish.

Who is your current therapist?
1. I enjoy working with my therapist
2. My therapist understands me and my needs
3. I feel comfortable talking about anything I want to share with my therapist
4. My therapist and I collaboratively set or are setting treatment goals, and I understand the direction my therapy is going in
5. My therapist is helping me work on useful skills to manage situations, thoughts, and emotions
6. I have helpful assignments or goals that I work on between sessions to implement the concepts we discuss in therapy
7. My therapist is responsive when I try to contact them
8. Working with my therapist has been beneficial to me
9. I would like to continue working with my therapist (if you do NOT want to continue and you would like to try a different provider, please share your most recent appointment time at the end of the survey so that you can be matched with one)
Would you like a director of the practice to contact you about your feedback? (Select all that apply)
Would you like your feedback to be shared with your therapist?
For example: 10/31/22, 2PM EST. Note: if you are seen by a director (Dr. Alice Thornewill or Dr. Suraji Wagage), the director who is not your therapist will review your feedback and contact you.