SSPC Client Session Feedback Form
Met with a counselor? Let us know how we're doing!
What was the date of your meeting?
MM
/
DD
/
YYYY
What time was the meeting?
Time
:
What did the counselor do well?
Your answer
How can we do better? What did you like/not like? (The more specific, the more helpful it is for us to improve. Examples: Was the environment welcoming? How was the counselor's body language? Did they make you feel welcome or listened to?)
Your answer
Overall, how satisfied were you with the experience?
not satisfied at all
very satisfied
Additional comments
Your answer
COMPLETELY OPTIONAL: Would you like us to followup/respond? (If yes, please provide an email for us to contact you at. It does not have to be one that identifies you. It will be kept confidential.) Leave blank otherwise.
Your answer
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