* Indicates required fields

    Your Name*:

    Today's Date*

    Please rate today’s session by choosing a number nearest to the description that best fits your experience.

    Relationship*

    I did not feel understood, respected, &/or accepted by the therapist

    I felt understood, respected, and accepted by the therapist

    Goals and Topics*

    We did not work on or talk about what I wanted to work on and talk about

    We worked on and talked about what I wanted to work on and talk about

    Approach or Method*

    The therapist's approach is not a good fit for me

    The therapist's approach is a good fit for me

    Overall*

    There was something missing in today's session

    Overall, today's session was right for me