Name

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First Name

Last Name

Did you call first and then referred to the New Client Inquiry form online?

Yes

No

How would you rate the ease of filling out the online intake form?

Very Difficult

Difficult

Neutral

Easy

Very Easy

Were the instructions on the online intake form clear and easy to follow?

Not clear at all

Somewhat Clear

Very clear

Did you encounter any issues or confusion while completing the online intake form?

Yes

No

How easy was it to access the ClientCare portal?

Very difficult

Difficult

Neutral

Easy

Very Easy

Did you encounter any issues while accessing the client portal?

Yes

No

Were the instructions to access the ClientCare portal helpful?

No

Somewhat

Yes