Psychotherapy Survey

Psychotherapy/Counseling Survey

Please complete the survey below and submit. Your name and email address are not requested so as to maintain your anonymity.

(1) Your Age: (2) Your Sex: Male Female
(3) Education:
Less than High School High School College Graduate Degree
(4) Have you ever been in therapy or counseling? Yes No
If "Yes" to question (4), did you see a psychiatrist psychologist social worker other don't know profession	If "Yes" to question (4), how long were you in therapy/counseling? 1 week to 1 month 1 month to 3 months 3 months to 6 months 6 months to 9 months 9 months to 1 year 1 year to 2 years > 2 years
If "Yes" to question (4), did you find the therapy or counseling helpful? Not at all Somewhat Very Helpful
If "No" to question (4), if it were appropriate, would you consider seeing a therapist? Yes No
	If "Yes," would you prefer to see a psychiatrist psychologist social worker other profession doesn't matter
If "No" to the above, please comment as to why you would not see a therapist

Thank you for filling out the form and submitting it.