CLIENT SURVEY Customer Feedbacks Please take a few minutes to give us feedback about your experience at Solidminds Please enable JavaScript in your browser to complete this form.DateGenda *MaleFemalePrefer Not to SayAge Group *12 or Younger13 -1819 – 2425 – 4040 – 5050 – 6060 +Approximate Number of Months in Therapy *Less than 11 – 33 – 66 – 99 – 12Over 12My first contact with Solid Minds was positive *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeI felt Solidminds responded to my need in a timely manner *Strongly AgreeAgreeNeutralDisagreeStrongly Disagree Months Minds information) Appointment and scheduling procedures were clearly communicated *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeMy counselor listened and understood the concerns I brought to counseling. *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeMy counselor helped me develop better ways of coping with the problems, feelings or situation that brought me to Solidminds. *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeI trust that my counselor will maintain my confidentiality *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeI would refer friends to Solid Minds *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeI would return for counseling if I felt the need. *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeMy experience at Solidminds has positively affected my life. *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreePlease rate the overall level of distress that brought you to counseling *Strongly AgreeAgreeNeutralDisagreeStrongly DisagreePlease include any other comments you would like to add about your experience at Solidminds First Name: *Last Name: Therapist's Name: *May we use your comments (without your name or any identifying information) in our printed materials and website? *YesNoSubmit
