Name (Not Required)
First Name
Last Name
Counselor Name
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We ask this only so that we can give direct feedback to our clinical staff. Please complete another survey if you work with multiple therapists.
Please rate your experiences with your counselor (Strongly Disagree to Strongly Agree):
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If you work with more than one counselor, please submit more than one survey. This is so we are better equipped to provide direct feedback to each staff member. If you no longer attend sessions, please think back to when you were attending.
(-) I can comfortably talk about my issues with my counselor and feel ease with them. (+)
(-) My counselor understands me and the concerns I have. (+)
(-) The counselor offers relevant information that is helpful. (+)
(-) Counseling has helped me make progress towards my goals. (+)
(-) I feel like my counselor's approach is a good fit for me. (+)
(-) My counselor is receptive to my wishes and feedback. (+)
What further feedback can we pass on to your counselor to help them improve for the next client?
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Please rate your experience with our administrative staff and environment:
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Tell us how our staff doing with communication, scheduling, and financial issues.
It was easy to schedule my first appointment and get a cost estimate.
The staff did his/her best to answer my questions about insurance, billing, and finances.
The front desk staff are professional and friendly.
The lobby, common areas, and office environment are welcoming and clean.
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Do you have any suggestions for our support staff and/or environment?
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Please tell us about your overall experience.
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Yes, I would refer a friend, family member, or colleague to Summit Family Therapy.
Do you have any additional feedback so we can continue to improve our services for future clients?
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