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Hull DAP Child Evaluation Form

How I feel after therapy:

1. Are you feeling safer?
2. Are your relationships with your parent or parents getting better?
3. Are you getting on better with your brother(s) and / or sister(s)?
4. Are you getting on better with your friends?
5. Are you getting on better with your family as a whole?
6. Are you doing better at school?
7. Do you know how to have positive and healthy relationships with your friends and family?
8. Do you feel happier, less worried and / or calmer?
9. Do you think your therapy sessions are helping you?

Is there anything else you would like to tell us?

Date form completed

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?

Should you wish to discuss your feedback in any greater depth, please speak with your therapist or contact:

Julie White, Clinical Director
Time to Listen CIC
Marvell House Children’s Centre
Cranbourne Street
HULL,
HU3 1PP

Email: julie.white@timetolisten.co.uk
Mobile: 07508845512

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

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

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