Client Survey

This client survey is optional and can also be anonymous. Sharing your name is NOT required and you can skip any questions (except for your coach's, therapist's, or dietitian's name).

Name (optional)
What was your provider's name?

Please select the answer that most accurately describes your feelings.

My provider treated me with respect.

My provider did a good job listening.

I trusted my provider.

My provider seemed knowledgeable and skilled.

I felt most of my sessions were productive.

I accomplished the goals I came hoping to accomplish.

The techniques my provider used were helpful.

I was happy with the amount of homework my provider gave me.

What do you feel was the most beneficial change in your life as a result of working with your provider?

Is there anything you wish your provider had done differently or could have done better?

Is there any other feedback you'd like to share with us?

Please indicate whether or not you consent to any portions of your feedback being used in a client testimonial. Again, this is NOT required.