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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