Client Feedback Form
It is particularly important to me to assess the impact and quality of the service I provide. I would appreciate you taking a few minutes to give me feedback on the service you received from me. I am happy to have both positive and negative feedback so please feel free to give me your honest views.  You can complete this anonymously or add your contact details if there is anything you wish me to address.
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1. To what extent would you say that counselling has been helpful to you?
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2. To what extent would you say that counselling has helped you address the issue(s) that were your reason(s) for coming to counselling?
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3. In what ways do you think your counsellor has helped you?
4. Would you recommend this counselling service to a friend?
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5. Please describe in more detail the ways in which counselling helped you.
6. Please also tell any ways in which you found counselling or any aspects of the service unhelpful.
Please use this space to add any other comments or suggestions:
May I use your comments as a testimonial?
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If you would like me to address anything in this feedback, please add your name and email address below:
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