Time to Listen logo

We specialise in working with children, young people and families, but also provide counselling for adults

Counselling Feedback Form

Private and Confidential

We would like to know how helpful your meetings with your counsellor have been. It would really help us if you would fill this in!

 1. What do you think about where the counselling takes place?

 

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unhappy

Did you like the room you were in?

Was it quiet?

Did you feel safe?

2. We would like some information about your counsellor.

First name of Counsellor

 

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unhappy1

My first meeting with my counsellor

My counsellor was easy to talk to

They listened to me

I felt safe with them

I was able to talk to them

They helped me with my problem

3. How helpful have you found the counselling?

It helped me to:-

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See things more clearly

Understand my problems

Understand myself better as a person

Start to make some good choices

Feel better

Feel more confident about myself

4. If you needed to would you use the counselling service again?

Yes No

5. Would you recommend the counselling service to other young people in need of help?

Yes No

6. Was there anything you disliked about the counselling?

7. What do you think could improve the counselling service?

Is there anything else you would like to tell us?

Date form completed

Name of the person completing the form

Would you be willing for your comments to be anonymously used in our publicity and service evaluations? For example, cited on our website and shared with Ofsted?

Yes No

Are you happy for your comments to be shared with your counsellor / therapist and other members of the Time to Listen Team?

Yes No

Your completed form will be shared with your Social Worker, if applicable, as part of our regular review process.

Thank you for taking the time to complete this form and sharing your feedback