How effective in helping you deal with your issues was the work we did ?

How satisfied are you with me as a therapist ?

Would you recommend me to others?

Name

Thank you for taking the time to complete this feedback form

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Very Effective

Effective

Ineffective

Very Ineffective

Yes

No

Please add any comments you wish to make

Is it OK to quote your comments on my ‘Feedback From Previous Clients’ page providing your identity remains concealed?

Yes

No