Form

Quetzal Service Evaluation Form
If Known

Client numberName (optional)
How did you originally hear about Quetzal?
Which Quetzal services have you used?

Telephone CounsellingCrisis CounsellingFace to Face CounsellingOnline Support packageVideo call counsellingGroup sessionsCheck and ChatSingle Session TherapyNone of the above
If you did not go on to have counselling with Quetzal, or stopped counselling with us early, could you tell us why?

Thinking about the service you received, how far would you agree with the following statements?

	Strongly Agree	Agree	Neither	Disagree	Strongly Disagree	N/A
I felt Quetzal maintained good contact with me from referral to starting therapy
I felt Quetzal met my personal and cultural needs
It was important to be seen by a female counsellor
I felt my counsellor was properly skilled to support me
I would recommend Quetzal to others
The waiting time for assessment and therapy was acceptable
I felt that people listened to me
It was easy to talk to the people who saw me
I was treated well by the people who saw me
My views and worries were taken seriously
The facilities were comfortable
My appointment was at a convenient time
Overall the help I received was good

Please tell us how we could improve our services.
Is there anything else you would like to tell us about the service you received?
Please tell us in your own words how counselling made a difference to you, or your life.
From time to time we include anonymous comments from questionnaires in reports to our funders, social media or website. Would you be happy for us to include your words?

NoJust Social media and websiteJust funders reportsEither/Both
Would you be happy for Quetzal to contact you regarding the answers in this survey?

YesNo
Should be Empty:

Quetzal Service Evaluation Form