WC CIC Feedback Survey - Adults and Young People. This is  confidential.

Evaluation form for clients to give thoughts and feedback on the counselling service. Thank-you.

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* 1. What do you think about where the counselling takes place?

  Agree Strongly Agree Disagree Disagree Strongly
I think the location is easy to find
I think the location is convenient
I think the room is comfortable
I think the room is private
I think the room is quiet

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* 2. Did you feel you got your appointment quickly enough?

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* 3. How did you find out about our service? Was the service free or did you pay? What kind of difference does having access to free/ affordable Counseling make to you?

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* 4. How many counselling sessions did you have and did you feel this was enough?

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* 5. We would like some information on your relationship with your counsellor.

  Strongly Agree Agree Disagree Strongly Disagree
My first impression of my counsellor was a positive one.
I feel my counsellor is easy to talk to.
I feel my counsellor is someone who really listens.
I feel my counsellor is supportive.
I feel my counsellor is someone who gives me confidence.
I feel my counsellor is someone who has helped me deal with some difficult issues.
I feel my counsellor is someone who does not judge me.

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* 6. Please enter the first name of your counsellor:

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* 7. How helpful have you found counselling?

  Strongly Agree Agree Disagree Strongly Disagree
It has helped me to see things more clearly.
It has helped me to understand my problems.
It has helped me to understand myself better as a person.
It has helped me to start to make some changes.
It has helped me to feel better.
It has helped me to feel more confident about myself.

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* 8. If you needed to, would you use the counselling service again in the future?

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* 9. Would you recommend the counselling service to other people?

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* 10. Please leave a short review of the service that we could use as a testimonial or to improve our service.

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