Thomas Callahan, Ph.D.
Educational Consultant
(401) 845-6682
Post Office Box 1189
Newport, RI  02840

     
Customer Satisfaction Survey
 
   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Qualifications
& Experience

Services for
Families
in Crisis

Services for Referring
Professionals

Request for
Services Form

Resource
Center

E-mail

Newport


 
To help me better evaluate my performance, please complete the following form.  

  Services received (please check all that apply):

    Interview with parents and child
    Educational Evaluation and Recommendations
    Psychological Evaluation and Treatment Recommendations
    Therapeutic/Emotional Growth Program Recommendations
    Therapeutic/Emotional Growth Program Placement Services
    Advocacy in Treatment Process
Quality of Services Provided: Excellent     Adequate    Poor
  Quality of Communications:

Excellent     Adequate    Poor
  Quality of Information Provided: Excellent    Adequate    Poor

  Before contacting Dr. Callahan, I felt  (please check all that apply):
Anxious Angry Assured Calm Capable
Clear-minded Confident Confused Contented Depressed
Disappointed Embarrassed Empowered Focused Frustrated
Guilty Happy Hopeful Hopeless Ineffective
Optimistic Positive Satisfied Trapped Useless
Worried

  During the process I felt::


  Now I feel::


  Other Comments and Recommendations::


    I am comfortable referring families in need to Dr. Callahan::

Yes

No 
 

 

       

  

  Copyright 2000, Thomas Callahan