Client Feedback Form Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *PhoneOverall, how satisfied are you with the care you received at Insights Psychology?Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Please select your rating using the icons above, where 1 star represent poor experience, and 5 represent an excellent experienceHow satisfied were you with our scheduling process? Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5How satisfied were you with your first session?Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Which provider do you see?Dr. Arshi MuhammadMs. April BrandtDr. Hina SiddiquiDr. Iris MediniDr. Mollie NewhouseDid the provider begin and end your session on time?YesNoMy provider is a good listener.Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5I feel respected and not judged by my provider.Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5My provider helps me explore my options and solutions.DisagreeNeutralAgreeHow satisfied are you in general with your treatment provider?UnsatisfiedOkaySatisfiedWill you continue your treatment with us?NoMay beYesHow likely are you to refer a friend or family member to us? Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Is there anything we can do to improve your experience? Would you like the owner of the practice to reach out to you about your experience?YesNoSubmit For Patients Contact Us Request an Appointment HIPAA Secure Contact Form Client Feedback Survey Our Services Psychotherapy Psychological Evaluations Medication Management Telehealth Trauma Therapy Our Providers Self-Help Resources Insurance & Pricing Details Safety Resources Mental Health Resources Join Our Team Employment Opportunities Clinical Training Call: 651-273-1245 | Email: info@insightspsychology.org | Fax: 844-444-0292 © Copyright 2022 Insights Psychology, LLC. All Rights Reserved. Privacy Policy
