• Counselling Feedback Form

    This form allows you an opportunity to provide feedback to your counsellor after your sessions have finished. This will help your counsellor’s professional development as well as helping to improve the service offered to others. You DO NOT need to identify yourself. Please place a mark in the box which most closely corresponds to how you feel about each statement.

  • About the Working Relationship With Your Counsellor

  • My counsellor listened to me effectively.*
  • My counsellor understood things from my point of view.*
  • My counsellor focused on what was important to me.*
  • My counsellor accepted what I said without judging me.*
  • My counsellor showed warmth toward me.*
  • My counsellor fostered a safe and trusting environment.*
  • My counsellor began and finished our sessions on time.*
  • My counsellor followed my lead during our sessions whenever that was appropriate.*
  • My counsellor provided leadership during our sessions when/if that was appropriate.*
  • My counsellor challenged me when/if that was appropriate.*

  • About the Results of Working With Your Counsellor

  • The sessions with my counsellor helped me with whatever originally led me to seek counselling.*
  • Any changes which might have occurred in me as a result of my counselling have been positive and welcome.*

  • Overall Satisfaction

  • My overall level of satisfaction with the service provided by my counsellor is:*
  • Should be Empty: