Post-Therapy Survey

Thank you for choosing Integrated Anxiety Management for your therapy needs. We are
committed to providing our clients with the highest level of care and your feedback is an
important part of our continuing efforts to improve ourselves and our work. Please take
a few minutes to share your thoughts and experiences with us.

Name (Optional):

First

Last

Age: *Under 1818-2425-3435-4445-5455-6465 or over

Gender: *MaleFemaleNon-binaryPrefer not to sayOther

If other gender (please specify):

How did you hear about our services? *Referral from a healthcare professionalOnline searchSocial mediaWord of mouthOther

If other referral (please specify):

How long were you in psychotherapy with us? (Approximate number of sessions or duration in months) *

How would you rate the ease of the online registration process? *Very easySomewhat easyEasyNot easyDifficult

How would you rate the quality of communication about billing?Very responsive and transparentSomewhat responsive and transparentPoor responsiveness and transparencyUnhelpful

Please rate the effectiveness of the psychotherapy in helping you achieve your goals. *

• Extremely Effective
• Very Effective
• Effective
• Somewhat Effective
• Not Effective

Were you satisfied with your therapist's professionalism and competence?

• Very satisfied
• Satisfied
• Dissatisfied
• Very Dissatisfied

Additional comments about professionalism and competence:

How would you rate the quality of communication with your therapist?

• Excellent
• Good
• Fair
• Poor

Additonal comments about communication with your therapist:

process? the with

Did your therapist actively listen to your concerns and needs? *

• Always
• Often
• Sometimes
• Rarely
• Never

Did you feel comfortable discussing your issues with your therapist? *

• Very Comfortable
• Comfortable
• Uncomfortable
• Very Uncomfortable

Additonal comments about being comfortable discussing issues with your therapist:

How would you rate the ease of scheduling your therapy sessions? *

• Very Easy
• Easy
• Neutral
• Difficult
• Very Difficult (Please comment what caused this below)

Additional comments about ease of scheduling your therapy sessions:

Overall, how satisfied are you with the psychotherapy services you received? *

• Very Satisfied
• Satisfied
• Dissatisfied
• Very Dissatisfied

What did you like most about the therapy experience? *

Please share additional comment about any specific feedback or suggestions you have regarding your therpay experience. Is there anything you believe we can improve? *

Would you like us to contact you regarding any of your responses? *

• Yes
• No

Submit

Thank you for taking the time to complete this survey. Your feedback is greatly appreciated. If you have any further concerns or wish to discuss your experience in more detail, please don’t hesitate to contact us.