Therapist Evaluation Survey Please enable JavaScript in your browser to complete this form.Who is your therapist?(Choose one)Jimmy A. Snow, Jr.Lori AllenSandy AllenPrecious Wilkerson-CarrJessica VuLauren JonesTraci SimmonsJames MejiasDr. Latoya PierceMy therapist cares about me and wants to see me make healthy changes.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist demonstrates good boundaries by being professional, yet relatable and does not overshare about his/her personal life.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist does not touch me inappropriately and only initiates touch as a supportive gesture (handshake, pat on back, friendly hug) upon my consent.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist is qualified to address my specific concerns.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist does not frequently cancel or reschedule my sessionsYes/Always/AgreeSometimesNo/Never/DisagreeMy therapist maintains my confidentiality.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist has helped me reach personal goals.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist has demonstrated positive regard for me and has not judged me.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist creates a comfortable environment where I feel safe and valued.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist is not distracted by calls, texts, etc. during our sessions.Yes/Always/AgreeSometimesNo/Never/DisagreeMy therapist does not simply order me to do things, or readily give advice, but rather helps me explore options, pros/cons, etc. Yes/Always/AgreeSometimesNo/Never/DisagreeI feel I can discuss with my therapist any issues that I am uncomfortable with or unsure of regarding the therapeutic process or counseling relationship.Yes/Always/AgreeSometimesNo/Never/DisagreePlease rate your therapist on a scale of 1-10, 1 being poor, 5 being average, and 10 being excellent Selected Value: 0 CommentsThank you for your time. We appreciate your feedback! NameSubmit
