Client Info Inquiry Form-OLD - Bright Care Christian Counseling

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Bright Care Client Feedback Form

First Name (Optional)

Therapist NameTo assist us with evaluating our therapists please provide the name of your therapist or feel free to decline.

Overall, how would you rate the experience of your therapy at Bright Care Christian Counseling? *12345N/A

I felt like I was safe, heard, and respected. *AgreeDisagreeNeutralN/A

The therapist's approach was a good fit for me. *AgreeDisagreeNeutralN/A

I feel like therapy helped me feel less depressed, less anxious, less confused, or less unhappy. *AgreeDisagreeNeutralN/A

Was your treatment plan created and reviewed per your needs? *YesNoUnsure | N/A

Did you meet your goals for services? *YesNoUnsure | N/A

What would you like to have more of in therapy?

What would you like to have less of in therapy?

Something(s) I typically think about is/are

How satisfied are you with prompt response to your email/call? *UnsatisfiedNeutralSatisfiedN/A

How satisfied are you with scheduling an appointment? *UnsatisfiedNeutralSatisfiedN/A

How likely are you to return for another appointment? *UnlikelyNeutralLikelyN/A

How likely are you to recommend your therapist to others? *UnlikelyNeutralLikelyN/A

How likely are you to recommend Bright Care to others? *UnlikelyNeutralLikelyN/A

Additional Comments, Positive Feedback or Concerns, Questions, or Suggestions

Call (405) 795-7526 – 8am-8pm

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