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Half Moon Mental Health & Wellness Client Feedback Form

Thank you for sharing your feedback about your experience with us! We truly appreciate you taking the time to complete this form, as your opinions are important to us. Your responses will help us enhance our services and better serve both the community and our clients.


PLEASE NOTE: The information you provide is confidential and will only be reviewed by the Half Moon Office Oracle and Practice Founder. It will not be shared with your therapist unless you give us explicit permission to do so at the end of the form.

Your Therapist's Name

Please rate your experience at Half Moon based on the following statements:

“The office administrator was kind and responsive when providing information and scheduling my consultation.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“The office environment was welcoming and made me feel comfortable.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“The virtual session platform was user-friendly and did not disrupt the flow of our discussions.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“My therapist made an effort to understand me during our sessions.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“My therapist showed empathy and demonstrated a clear understanding of my views and experiences.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“Our sessions were focused on the aspects that were most important to me.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“I felt that my therapist was open and non-judgmental, creating a safe space for me to share.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“The therapeutic approach used by my therapist aligned well with my needs.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“My therapist demonstrated expertise and knowledge relevant to my specific concerns.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“The professionalism and experience shown by my therapist were apparent during our sessions.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“My therapist showed a deep understanding of LGBTQIA+ related topics and issues.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
“I felt supported and guided by my therapist in achieving my personal goals.”
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
My overall experience with my therapist was:
Excellent
Good
Neutral
Fair
Disappointing
N/A
Would you recommend this therapist to another person?
Yes
No
If you have discontinued therapy services, can you let us know why? (Feel free to select more than one option)
Can our Practice Founder contact you on any concerns you have expressed on this form?
Yes
No
If yes, how would you prefer to be contacted?
Phone
Email
Can we use your feedback for testimonials on our website or social media? (Your information will remain anonymous.)
Yes
No
Would you like us to share the feedback from this form with your therapist to help improve their services? (Your information will remain anonymous.)
Yes
No

Thank you once again for taking the time to provide us with your feedback.

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