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Barry F. Moss, Ph.D., Licensed Clinical Psychologist
Satisfaction Survey

Patient Satisfaction Survey

Your feedback about your experience in therapy is valuable to ensuring the highest quality of service. Please take a few minutes to complete this brief and anonymous survey. Your participation is greatly appreciated.

Using the rating scale below, please enter the numeric answer that best represents your view for each question.

Therapist: Barry F. Moss, Ph.D.

5-Yes,Definitely  4-Yes,Generally  3-Neutral  2-No,Not Really  1-No,Definitely Not,  0-NA

Did you get the kind of service you wanted?
Were you satisfied with the skill level of your therapist?
If a friend were in need of similar help, would you recommend your therapist to him/her?
Are you satisfied with the amount of help you have received?
Have the services you received helped you to deal more effectively with your problems?
If you were to seek help again, would you come back to your therapist?
In general, did you feel therapy was a good use of your time?
Has therapy allowed you to learn new methods or techniques for solving your problems?
Were you able to trust your therapist?
Were you able to establish a good rapport with your therapist?
Did you invest a lot of energy in your therapy?
If testing was performed, did you find the feedback helpful?
Did you meet your goals for therapy?
Were you satisfied with the scheduling of your therapy?
Did you find the office location to be convenient?
Were you satisfied with the billing and handling of your account?
Were you satisfied with the parking and ease of access?
Was the atmosphere of the office comfortable?
Were you satisfied the voice mail service?
If referrals to other health professionals or services were made, were you satisfied with the referral?
Overall, were you satisfied with your experience in therapy?
Please provide any additional thoughts or feelings about your experience in therapy: