LivingRite Client Survey

Client Name (Optional)
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Gender
Name of your Provider
Office Location
Visits with your Provider
Thinking about your provider, how would you rate:
1. How prepared this provider was for your visits...
2. Attention this provider paid to what you had to say...
3. How well this provider understood your concerns...
4. Length of time between visits with this provider...
5. How accessible your provider was to you and your needs...
6. How much this provider made you feel that they cared about your progress...
Continuing to think about the visit(s) you've had with your provider, please rate your agreement with the following statements:
1. This provider focused on achieving the goals for my counseling or treatment...
2. This provider gave me as much information as I wanted about what I could do to manage my condition...
3. This provider helped me obtain skills that will help me handle future problems...
4. This provider helped me define my needs...
5. I felt comfortable and safe during my therapy session(s)...
Are there some things you feel were especially good or helpful about your experience with your provider or LivingRite as a whole?
Do you have any specific concerns or complaints about your experience with your provider, or LivingRite as a whole?
How likely would you be to recommend this provider to a friend or family member?
Setting up an Appointment
Your first interaction with LivingRite (before you had been matched with a provider) was with our website or staff employed by LivingRite. Thinking back to that first contact you made with LivingRite to set up an appointment, please rate your agreement with the following statements:
1. Friendliness and helpfulness of staff when you contacted us.
2. Ease of getting the counseling or treatment you requested.
3. The intake process (new client forms, insurance verification, etc) was simple and easy to complete.
4. The website was easy to navigate, and the information was relevant and informative.
5. All things considered, how satisfied are you with LivingRite's behavioral health services?
Would you like to submit a testimonial? (Please note that by doing so you are agreeing to have your submission anonymously displayed on our website)
Testimonial and/or Comments:

LivingRite Client Survey

Visits with your Provider

Setting up an Appointment