Nassau Guidance Counseling Centers - Individual counseling, family therapy, cognitive therapy, behavioral therapy
 
 

In our effort to provide an ongoing Quality Assurance program, it is important to hear from our clients. We are constantly striving to improve our focus, and your valued input about our site and/or services will help us to achieve our goal of providing the best care possible. This feedback form is intended for comments and suggestions for our site and services provided.  Please take a moment to offer us your opinion by completing and submitting the evaluation/feedback form. All information will be held in strictest confidence.

First Name:
Last Name:
Street Address:
City:
State:
Zip Code:
Email Address
(optional)
Do you wish to be contacted by the director?
Yes
No
Contact Phone:  
How did you hear about us?   
Internet
Super Pages
Newspaper 		Yellow Pages
Other
Were you treated professionally?
Yes
No
Did you feel that your therapist had the skills/knowledge necessary to help you?
Yes
No
Was the waiting area comfortable and clean?
Yes
No
Did you feel you would be better served by another therapist?
Yes
No
What could have made the experience better for you?
We encourage comments and suggestions about our website.
Comments: