Client Feedback Form * Client Feedback Form * Client Feedback Form * For New Clients Whose your therapist? * Dominique Laroneje How was your first session? * What stood out to you in your initial session? * At any point in your session, did you feel uncomfortable? If so, please share what made you feel this way. * Would you recommend your therapist and/or Well Grounded Therapy PLLC to a friend, coworker or family member, etc.? * Yes No Maybe Are you comfortable with your testimonial/feedback to be posted on the Well Grounded Therapy website anonymously? (This is not for Google, Yelp, etc.) * Yes No Thank you!