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?
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
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:-
See things more clearly
Understand my problems
Understand myself better as a person
Start to make some good choices
Feel more confident about myself
4. If you needed to would you use the counselling service again?
5. Would you recommend the counselling service to other young people in need of help?
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?
Are you happy for your comments to be shared with your counsellor / therapist and other members of the Time to Listen Team?
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
Time to Listen Limited
Marvell House Children's Centre, Cranbourne Street, Kingston upon Hull HU3 1PP
M: 07810 503830 E: Time to Listen email link
Registered in England 08557572Gail Thornton — Registration No. 016081 on the BACP Register of Counsellors & Psychotherapists.
Ofsted Registered 1250134
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