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CLIENT EXPERIENCE SURVEY

Client Experience Survey

Your feedback helps us improve our services. This survey is anonymous and voluntary. Thank you for taking a few minutes to share your experience.

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1. Overall, how satisfied are you with the services you have received?

Very Dissatisfied

Dissatisfied

Neutral

Satisfied

Very Satisfied

2. I feel respected and treated with dignity during my appointments.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

3. I feel comfortable expressing my thoughts and feelings during therapy.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

4. My therapist listens carefully and responds in a helpful way.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

5. Since starting services, I feel I am making progress toward my goals.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

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If you have worked with a student intern, please answer the following:

6. The student intern treated me professionally and respectfully.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I have not worked with a student intern

7. I felt comfortable receiving services from a student intern.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Not Applicable

8. If applicable, I would be willing to work with a student intern again.

Yes

Maybe

No

Not Applicable

9. What has been the most helpful part of your therapy?

10. Is there anything we could do to improve your experience?

Would you like to give your name? This is optional.

Thank you for filling out the Client Experience Survey. If you need further assistance, please call our office at (505) 633 7886.

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(505) 633-7886

kgillis@sandiatherapy.com

6612 Gulton Ct NE Ste B,

Albuquerque, NM 87109

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