Evaluation/ Feedback Survey

Can your response be shared publicly?

Your response will only contain your initials:

For the following statements, please rate each of the statements on a scale 1-5, where 1 is poor and 5 is excellent.

Overall how would you rate your experience? (where 1 is poor and 5 is excellent)

My therapist fosters a safe and trusting environment. (where 1 is poor and 5 is excellent)

My therapist treats me with respect. (where 1 is poor and 5 is excellent)

I'm able to express my feelings and thoughts freely, without judgement. (where 1 is poor and 5 is excellent)

I have learned some new ways to deal with my problems. (where 1 is poor and 5 is excellent)

The overall atmosphere and quality of facility is professional and welcoming. (where 1 is poor and 5 is excellent)

I believe sessions have been helpful to me. (where 1 is poor and 5 is excellent)

I am able to get in contact with my therapist in a timely manner. (where 1 is poor and 5 is excellent)

Please provide as much detail as you wish for the following questions.

How has your therapy experience with Sarah Newman, LCSW impacted you?

Is there anything that could be done to improve patient care and/or experience?

Would you recommend Restore Mental Health, PLLC / Sarah Newman, LCSW to others?

What are the main reasons why you would or wouldn’t recommend Restore Mental Health, PLLC/ Sarah Newman, LCSW to other patients?

Any additional comments/ feedback you would like to bring to your therapist's attention?