In order to help us evaluate the counselling service we need your feedback. Your answers will be treated confidentially and you do not have to give your name.
1. What do you think about where the counselling takes place?
I think the location is easy to find
I think the location is convenient
I think the room is comfortable
I think the room is private
I think the room is quiet
2. Did you feel you got your appointment quickly enough?
If 'No', how long did you have to wait?
3. Did you check us out on the website?
If 'Yes' what did you think about it?
4. We would like some information on your relationship with your counsellor.
First name of Counsellor
My first impression of my counsellor was a positive one
I feel my counsellor is easy to talk to
I feel my counsellor is someone who really listens
I feel my counsellor is supportive
I feel my counsellor is someone who gives me confidence
I feel my counsellor is someone who has helped me deal with some difficult issues
I feel my counsellor is someone who does not judge me
5. 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 changes
Feel more confident about myself
6. If you needed to would you use the counselling service again in the future?
7. Would you recommend the counselling service to other young people in need of help?
8. Was there anything you disliked about the counselling?
9. What do you think could improve the counselling service?
10. Any Further Comments that you would like to make?
11. Date form completed
12. Name of the person completing the form
13. 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?
14. 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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