Survey
We appreciate your feedback! Please take a moment to complete this survey about your counselling experience.
Your Name (Optional)
First Name
Last Name
Email Address (Optional)
example@example.com
How satisfied were you with your counselling experience?
Very Dissatisfied
0
1
2
3
4
Very Satisfied
5
0 is Very Dissatisfied, 5 is Very Satisfied
What issues did you seek counselling for?
How effective did you find the counselling sessions?
Not Effective
0
1
2
3
4
Very Effective
5
0 is Not Effective, 5 is Very Effective
Would you recommend our counselling services to others?
Yes
No
What did you like most about the counselling sessions?
What improvements would you suggest?
Any additional comments or feedback?
Submit
Should be Empty: