“All feedback is a gift…” — Valerie Houghton Name * First Name Last Name Email * Phone (###) ### #### Please answer the following survey questions. * I was satisfied with Valerie's expertise and responsiveness during our time working together. Strongly Disagree Disagree Neutral Agree Strongly Agree Scheduling appointments with Valerie was easy. Strongly Disagree Disagree Neutral Agree Strongly Agree Valerie was highly effective at meeting our goals. Strongly Disagree Disagree Neutral Agree Strongly Agree I would strongly recommend Valerie to a friend or colleague. Strongly Disagree Disagree Neutral Agree Strongly Agree Any further suggestions? (Most helpful? Areas you'd like to see improve?) Do I have your permission to redact your identity, your clinical details, and use your feedback on my website and/or social media? (It's okay to say no) YES NO Thank you for your feedback!