ASU Mental Wellness Survey

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Name
This is NOT your SSN. Refer to the registration sign-up email for your client number, please use the full ID.
Please use the drop-down menu to choose your Provider.
Session Date / Time
Is this your last session?
Overall, how would you rate your experience with us?
How satisfied were you with
UnsatisfiedNeutralVery Satisfied
Your Treatment
Unsatisfied
Neutral
Very Satisfied
Timely Session Scheduling
Unsatisfied
Neutral
Very Satisfied
Technology
Unsatisfied
Neutral
Very Satisfied
Program Meeting Your Needs/Expectations
Unsatisfied
Neutral
Very Satisfied
Facility/Physical Environment
Unsatisfied
Neutral
Very Satisfied
How likely are you to
UnlikelyNeutralLikely
Schedule a new appointment
Unlikely
Neutral
Likely
Recommend this provider to others
Unlikely
Neutral
Likely
Recommend BLHF Services to others
Unlikely
Neutral
Likely
Participate in another program like this
Unlikely
Neutral
Likely
Have you scheduled a follow-up visit with this provider?
How did you feel before the session started?
How do you feel after the session?
We're sorry you if did not have a good experience. Please let us know how we can do better.