Psychological Feedback Survey Form
Please provide your honest feedback to help us improve our psychological services. All responses are anonymous and confidential.
How satisfied are you with the overall quality of the psychological services you received?
*
1
2
3
4
5
How comfortable did you feel during your session(s)?
*
Not comfortable at all
1
2
3
4
Extremely comfortable
5
1 is Not comfortable at all, 5 is Extremely comfortable
How likely are you to recommend our psychological services to others?
*
Not likely
1
2
3
4
Very likely
5
1 is Not likely, 5 is Very likely
How well did your psychologist listen to your concerns?
*
Not at all
1
2
3
4
Extremely well
5
1 is Not at all, 5 is Extremely well
Please indicate your level of agreement with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I felt respected during my session(s)
1
2
3
4
5
The session(s) met my expectations
6
7
8
9
10
The psychologist provided clear explanations
11
12
13
14
15
Which aspect of the service was most helpful for you?
*
Active listening
Practical advice
Emotional support
Resource recommendations
Other
Did you experience any challenges or barriers in accessing our services?
*
Yes
No
How easy was it to schedule your session(s)?
*
Very difficult
1
2
3
4
Very easy
5
1 is Very difficult, 5 is Very easy
What could we do to improve your experience?
Any additional comments or suggestions?
Submit Feedback
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