I would like to invite you to provide feedback about the services you have received in an effort to ensure and improve quality of care. This is completely voluntary, and all responses will remain anonymous.

1. Please indicate the approximate length of your time in therapy with Kalee Gower, LCSW.

2. Please indicate which type of therapy you receive. Check all that apply.

Individuals

Couples

Group

3. Were phone calls returned and appointments scheduled in a timely manner?

4. Do you feel like you have reached or are working towards reaching your therapeutic goals? Any comments can be included in the box below.

Comments:

5. Would you be likely to recommend Kalee to friends and family?

6. Can you please rank your overall experience with Kalee?

From 1 being completely unsatisfied to 10 being completely satisfied

7. Would you like to provide any suggestions to improve my services? If so, please indicate below.

8. If you have any other feedback regarding the switch to teletherapy, please leave comments below

9. If you would like to leave a written review about your experience with me to assist others in choosing the right therapist, please leave that below. These will be included on my website, and will remain anonymous.