WE’RE LISTENING

Please provide us with the following feedback about your experience at Groundwork Therapy.

Completed surveys are anonymous.

Who is your therapist?(required)

If you received multiple services at Groundwork Therapy, please check all therapists that apply.

How long have you been meeting with your therapist?(required)

Check multiple options if engaged in more than one therapy service.

Less than one month

One month to five months

Six months to one year

Over one year

Over two years

What service(s) have you received?(required)

Individual Therapy

Couples Therapy

Group Therapy

Are you satisfied with your therapist?

Extremely Satisfied

Satisfied

Neutral

Dissatisfied

What positive, negative, and/or constructive feedback can you give about your therapy experience?(required)

Would you recommend Groundwork Therapy to someone you know?(required)

Select an optionYesNoUnsure

Is there any other feedback you’d like to give?

If you discontinued therapy, why did you end?

If you discontinued therapy, would you return to your therapist in the future if needed?

Please provide your email address below if you would like one of the directors of the practice to write you to further discuss your feedback.

Send