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

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    … understood things from my point of view

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    … focused on what was important to me

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    … did not judge me

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    … showed warmth toward me

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    … created a safe and trusting environment

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    … began and finished on time

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    The results of therapy:

    I am satisfied with the approach taken during my session(s)

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    The therapeutic process met my needs

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    The concerns that brought me to FSPEI have improved as a result of my appointments

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    Overall satisfaction:

    My initial inquiry was addressed in a timely and helpful manner

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    The interaction with other staff left a positive impression

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    Overall, I am satisfied with the service provided to me

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

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