Mid-Treatment Feedback From

At Mindful Living, we are always looking for ways to improve our service. Client feedback plays an important role in helping us do that.

We understand that sharing feedback, especially in a therapeutic space, can feel uncomfortable at times. But it can also be a meaningful part of the work, offering an opportunity to reflect on what’s helpful and what could be adjusted.

We’d appreciate it if you could take a few moments to complete the form below and share your thoughts.

Name

How are things going so far?

Please rate the following statements:

Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
Selected Value: 1
1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
How many sessions have you had with your clinician?
Would you like to be contacted regarding your feedback?

Thank you for taking the time to provide your feedback!