Counselling and Therapy Services Feedback Form. Your participation in this survey is very much appreciated, thank you.

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* 1. Which service did you access?

Face to face counselling

Phone counselling

Email counselling

Instant messaging counselling

Video counselling

Art therapy

Other service (please specify)

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* 2. Remembering the changes you wanted to make in your life before accessing this service has your experience with Safeline helped you to make these changes? Please rate where 1 is Not at all and 10 is Yes it's been really helpful.

1 (Not at all)

10 (Yes it's been really helpful)

1 (Not at all)

10 (Yes it's been really helpful)

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* 3. Could you share what these or other changes are? For example, something specific that your experience with Safeline enabled you to do or to stop doing which could be a way of thinking, feeling or behaving.

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* 4. How do you rate the particular service you received at Safeline? Please rate where 1 is very poor and 10 is very good.

1 (very poor)

10 (very good)

1 (very poor)

10 (very good)

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* 5. Are there any comments you would like to make about the service? For example, things you have found helpful or unhelpful or how we may improve our services.

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* 6. If you used Taste of Recovery, the online self-help programme, how would you rate it in terms of usefulness? Please tick, 1 is very poor and 10 is very good.

1 (very poor)

10 (very good)

1 (very poor)

10 (very good)

Please use the space below if you would like to share anything about your experience of this service.

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* 7. Would you recommend our service?

Yes

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* 8. How helpful did you find our website and the information you received from us? Please rate where 1 is Not helpful and 10 is Really helpful

1 (Not helpful)

10 (Really helpful)

1 (Not helpful)

10 (Really helpful)

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* 9. If you visited our Safeline offices and counselling rooms how welcoming and comfortable did you find the environment and how might we improve upon this?

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* 10. Please can you describe your gender

Male

Female

Prefer not to say

Other (please specify)

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* 11. Would you consider yourself from a marginalised or disadvantaged group?

Yes

Not sure

Prefer not to say

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* 12. Were you given the choice of the gender of the person supporting you?

Yes

Not sure

Comments

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* 13. Do you have any feedback about our marketing, promotional materials or our social media posts?

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* 14. We would like to use your feedback for purposes such as for research, funding applications, to monitor and improve our services and to help promote the service. All responses remain anonymous.
Do you give consent for us to use your responses anonymously? Please tick as appropriate:

Yes. I consent to you using my responses

No. I do not consent to you using my responses

Please put in the feedback box provided or return in the pre-paid envelope. Alternatively, you can complete online at:
https://www.surveymonkey.co.uk/r/RCYLRVP
Thank you

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* 15. Would you like to become a member of our user involvement panel and help shape what we do and how we do it, give us your opinion on our information and services to inform and improve survivors’ experience of Safeline? If you’re interested, please get in touch via the contact details below. Thank you

Safeline
6A New Street
Warwick
CV34 4RX

Tel: 01926 402498
Email: office@safeline.org.uk

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* 1. Which service did you access?

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* 2. Remembering the changes you wanted to make in your life before accessing this service has your experience with Safeline helped you to make these changes? Please rate where 1 is Not at all and 10 is Yes it's been really helpful.

Question Title

* 3. Could you share what these or other changes are? For example, something specific that your experience with Safeline enabled you to do or to stop doing which could be a way of thinking, feeling or behaving.

Question Title

* 4. How do you rate the particular service you received at Safeline? Please rate where 1 is very poor and 10 is very good.

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* 5. Are there any comments you would like to make about the service? For example, things you have found helpful or unhelpful or how we may improve our services.

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* 6. If you used Taste of Recovery, the online self-help programme, how would you rate it in terms of usefulness? Please tick, 1 is very poor and 10 is very good.

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* 7. Would you recommend our service?

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* 8. How helpful did you find our website and the information you received from us? Please rate where 1 is Not helpful and 10 is Really helpful

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* 9. If you visited our Safeline offices and counselling rooms how welcoming and comfortable did you find the environment and how might we improve upon this?

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* 10. Please can you describe your gender

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* 11. Would you consider yourself from a marginalised or disadvantaged group?

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* 12. Were you given the choice of the gender of the person supporting you?

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* 13. Do you have any feedback about our marketing, promotional materials or our social media posts?

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* 14. We would like to use your feedback for purposes such as for research, funding applications, to monitor and improve our services and to help promote the service. All responses remain anonymous. Do you give consent for us to use your responses anonymously? Please tick as appropriate:

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* 14. We would like to use your feedback for purposes such as for research, funding applications, to monitor and improve our services and to help promote the service. All responses remain anonymous.
Do you give consent for us to use your responses anonymously? Please tick as appropriate: