Counseling and Psychological Services (CAPS) Feedback form

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Please provide your feedback about the services you received at CAPS. Your responses will assist us as we continue to improve our services. The information will remain confidential unless you provide your email at the end of the survey. Thank you.

1. Please rate how satisfied you were with the overall services you received at CAPS.

Totally Unsatisfied

Very Satisfied

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2. Please rate how satisfied you were with the counselor you saw at CAPS.

Totally Unsatisfied

Very Satisfied

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3. The services I received at CAPS helped me improve my emotional health.

Did Not Help

Helped Very Much

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4. The services I received at CAPS helped me maintain or improve my academic performance.

Did Not Help

Helped Very Much

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5. I would refer a friend to CAPS.

Definitely Would Not

Definitely Would

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6. Because of the services I received at CAPS I am likely to stay enrolled at SNC.

Definitely will not stay enrolled

Definitely will stay enrolled

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7. The approximate dates I was seen in CAPS:

Fall Semester

Spring Semester

8. The name of the counselor I saw was:

Lisa Burke

Tom Doughman

Bruce Robertson

Jenn Sovey-Fahey

Brittini Wester

Mason Van Rossum

Prefer not to answer

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9. Gender:

10. Year in School:

11. Please feel free to add any other feedback:

12. If you would like to be contacted by the Senior Director of CAPS regarding your feedback please enter your email address here.

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This form was created inside of St. Norbert College.