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Client Feedback Form
Please take a few moments to fill in the form. Thank you
Which Waratah Office did you attend?
Bunbury
Busselton
Collie
Manjimup
Margaret River
How was your overall impression of Waratah's Services?
1
2
3
4
5
6
7
8
9
10
Poor
Great
1 is Poor, 10 is Great
The following questions are about the Counsellor you saw most at Waratah. Please tick the box that best applies to you.
*
Rows
Strongly Agree
Somewhat Agree
No strong feelings
Somewhat Disagree
Strongly Disagree
The counsellor understood the main issue/s I brought to counselling and valued my opinions
The counsellor valued my knowledge of my own situation
The counsellor provided a safe and trusting environment
The counsellor helped me process and understand my experience of trauma
I trusted my counsellor
Feeling safe is important when you attend counselling. Was there anything about Waratah that made you feel unsafe or was there anything you feel could have been done better?
What things could Waratah change to improve the service?
How satisfied are you with the service you received at Waratah?
Very Satisfied
Satisfied
Neither
Dissatisfied
Very Dissatisfied
Would you recommend Waratah to other people?
Yes
No
We are always keen to improve our service. Please make any additional comment below
This form is anonymous, however if you would like someone to contact you regarding your feedback or experience at Waratah, please leave your name below.
You name
Thank you for completing our survey. We truly appreciate your feedback!
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