Employee Name *

First

Last

Employee Email *

What accomplishments have you been proud of since you started working at Roamers Therapy? *

How have you grown personally and professionally as a therapist in the past year? *

What feedback have you received from clients, colleagues, or supervisors, and how have you used it to improve? *

Can you provide examples of challenging cases you've handled this year and how you approached them? (Please be mindful of HIPAA) *

What successes or outcomes with clients are you most proud of from the past year? (Please be mindful of HIPAA) *

What new skills or therapeutic approaches have you learned and applied in the past year? *

How have you engaged in continuing education or professional development to enhance your practice? *

How have you integrated and contributed to the practice? *

What are the core strengths that help you excel in your position? *

Which skills haven’t you yet been able to showcase at work? *

How would you rate your relationship with your clients? *

Poor
Fair
Good
Excellent

What is your client retention rate? (clients who had 8 sessions and more) *

How have you managed work-life balance and self-care as a therapist in the past year? *

What strategies have you found effective in preventing burnout and maintaining your well-being while maintaining ethical and reliable responsibilities to clients? *

What are your professional goals for the upcoming year, and how do you plan to achieve them? *

Are there any specific areas of your practice or professional skills you would like to focus on improving in the next year? *

Which goals did you accomplish? And which ones you didn’t achieve? *

How did the supervision and the group training affect your professional career? *

How did you feel supported by the company and your colleagues this year? How could we support you more next year? *

What would you change about your role? *

Today's Date *

Signature *