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MWSP Youth Survey (PG County: Youth Symposium 2025)
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email Address
*
Date of Birth
*
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
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10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
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1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Client ID
*
Provider/Therapist
*
Dr. Aldith Campbell, LPA
Dr. An Ngo, LPA
Arnette Georges, LGPC
Dr. Blair Galiber-Smith, LPA
Bria Culp, LCPC
Clarafrancie Cromer Sowers, LCPC
Dr. Cynthia Harris, LCSW-C
Deborah Cunningham, LICSW
Eileen Vermilye, LICSW
Emily Sine, LICSW
Iesha Caisey, LCPC
Jessica Kessler, LICSW
Dr. Kendra Michael, LPA
Kevin Morton, LICSW
Dr. Lakitha Owens, LCPC
Marjorie Roberson, LICSW
Dr. Michael Leptic, LPA
Dr. Robert Mays, LICSW
Dr. Thuy-van Beauford, LICSW
Toni Session, LCPC
Tranesha Christie-Nance, LCPC
Vivian Clark, LICSW
Session Date
*
How well did you like your therapist?
*
Awful
Not Very Good
Okay
Really Good
Fantastic
Did the session meet your needs & expectations?
*
Awful
Not Very Good
Okay
Really Good
Fantastic
How did you feel about how long the session lasted?
*
Awful
Not Very Good
Okay
Really Good
Fantastic
How did you feel before the program started today
*
Awful
Not Very Good
Okay
Really Good
Fantastic
How do you feel now?
*
Awful
Not Very Good
Okay
Really Good
Fantastic
Comments
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