Feedback Forms

feedback-forms

We strive to provide you with the support you need in order to be successful. If you have accessed our services, we would ask that you complete a feedback form. Completing a feedback form is completely optional. However, we value all information you are able to give us so we can continually work to improve our programs and services.

Therapeutic Program Client Feedback Questionnaire

    We value your input. Please fill out this form as a way of letting Family Service PEI and your Therapist know how we can improve the services we offer.

    Please use the following scale to complete this form.
    1 - Strongly Disagree
    2 - Somewhat Disagree
    3 - No Strong Feeling
    4 - Somewhat Agree
    5 - Strongly Agree

    My Therapist …

    … listened to me 12345
    … understood things from my point of view 12345
    … focused on what was important to me 12345
    … did not judge me 12345
    … showed warmth toward me 12345
    … created a safe and trusting environment 12345
    … began and finished on time 12345
    The results of therapy:
    I am satisfied with the approach taken during my session(s) 12345
    The therapeutic process met my needs 12345
    The concerns that brought me to FSPEI have improved as a result of my appointments 12345
    Overall satisfaction:
    My initial inquiry was addressed in a timely and helpful manner 12345
    The interaction with other staff left a positive impression 12345
    Overall, I am satisfied with the service provided to me 12345

    What, if anything, could have been done to improve your experience?

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