Counselling with Kelly Evaluation Form
End of service feedback
How much did you feel you listened to and heard during the sessions?
Very much
Much
Neutral
Not much
Not at all
To what extend do you feel your point of view was understood?
Completely understood
Mostly understood
Neutral
Slightly understood
Not understood at all
How satisfied were you with the topics discussed and their relevance to you?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
How accepted and free of judgement did you feel during the sessions?
Completely accepted
Mostly accepted
Neutral
Slightly accepted
Not accepted at all
How safe and trusting did you find the counselling environment?
Very safe and trusting
Safe and trusting
Neutral
Slightly safe and trusting
Not safe and trusting
How much warmth did you feel from Kelly?
Very warm
Slightly warm
Neutral
Cool
Cold
How well were the sessions led by Kelly, where appropriate?
Very well
Well
Neutral
Poorly
Very poorly
Was the appropriate amount of challenge offered during the sessions?
Perfect amount
Would have liked more
Neutral
Not enough
Not at all
How well did the counselling help you with your original goals or expectations?
Exceeded expectations
Met expectations
Neutral
Below expectations
Far below expecations
Please use this space to write any other comments or to leave a testimonial of your experiences of counselling with Kelly. I welcome any constructive feedback as to what did or didn't work well for you.
Gender:
Female
Male
Other
Please state your gender if 'other' has been selected:
Please state your age:
To help others by sharing your experiences of working with me, I may like to anonymously add it to my website or social media. I will not use any personal or identifying details unless agreed, but it could be helpful to others to include gender and or age.
I agree to my comment being made public including gender and or age
I agree to my comment being made public not including gender or age
I do not agree to my comment being made public
Thank you for you time, Kelly
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