North Oakland Counseling, LLC - FEEDBACK FORM - Rochester, MI
North Oakland Counseling LLC   (248) 841-4080 - Therapy & Counseling for Individuals, Couples & Families
Client Feedback Form


This form Allows you an apportunity to provide feedback to your therapist. This will help improve the service offered to you and to others.
***You DO NOT need to identify yourself ****

PLEASE MARK THE BOX WHICH MOST CLOSELY CORRESPONDS TO HOW YOU FEEL EACH STATEMENT:

My therapist is:
Dina A
Tina K

ABOUT THE WORKING RELATIONSHIP WITH THE THERAPIST

I was given an appointment in a reasonable amount of time.
My therapist fostered a safe and trusting environment.
My Therapist Showed warmth toward me.
My therapist accepted what I said without judging me.
My Therapist listened carefully to my problems and needs and addressed them properly.
My therapist was professional and knowledgeable in helping me with my problems / concerns.
My therapist focused on what was important to me.
My Therapist challanged me when / if that was appropriate.
My therapist started and ended our sessions on time.

ABOUT THE RESULT OF WORKING WITH YOUR THERAPIST

The sessions with my therapist helped me with whatever originally led me to seek counseling.
I have learned valuable skills since I began therapy.
I can solve my problems more easily as a result of my therapy.
Any Changes which might have occured in me as a result of my counseling have been positive.

OVERALL SATISFACTION

My overall level of satisfaction with the service provided by my therapist is:
Based on my experience, I would recommend my therapist to others

Please use the space below for any further comments you would like to bring to your therapist's attention.
THANK YOU !
(Individual counseling, family counseling, couples and marriage counseling, counseling for children and adolescents, counseling for depression & anxiety, anger management, grief and trauma counseling, Rochester, Michigan) 
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