CLIENT OPINIONS OF YOUR EXPERIENCE AT BEST LIFE COUNSELING AND COACHING

First Name

Last Name

E-Mail Address

Please rate your therapy experience at Best Life Counseling

Please put a check in the circle the response that best describes your experience at Best Life Counseling

The Therapist Explained the Risks / Benefits of Therapy

	1 Highly agree
	2 Mostly agree
	3 Slightly Agree
	4 Neutral
	5 Slightly Disagree
	6 Mostly Disagree
	7 Highly Disagree

I was treated with respect by the therapist

	1=Strongly Agree
	2=Mostly Agree
	3=Slightly Agree
	4=Neutral
	5=Slightly Disagree
	6=Mostly Disagree
	7=Highly Disagree

The Treatment plan was explained to me

	1=Strongly Agree
	2=Mostly Agree
	3=Slightly Agree
	4=Neutral
	5=Slightly Disagree
	6=Mostly Disagree
	7=Strongly Disagree

I was satisfied with the counseling I received

	1=Strongly Agree
	2=Mostly Agree
	3=Slightly Agree
	4=Neutral
	5=Slightly Disagree
	6=Mostly Agree
	7=Strongly Disagree

I would return to the therapist (if needed)

	1=Strongly Agree
	2=Mostly Agree
	3=Slightly Agree
	4=Neutral
	5=Slightly Disagree
	6=Mostly Disagree
	7=Strongly Disagree

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Best Life Counseling and Coaching 12360 66th St. Suite A-1 Largo, FL 33773 Phone: 727-584-3600 Website: www.bestlifecounseling.com