We specialise in working with children, young people and families, but also provide counselling for adults

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?

Yes No

If 'No', how long did you have to wait?

3. Did you check us out on the website?

Yes No

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 better

Feel more confident about myself

6. If you needed to would you use the counselling service again in the future?

Yes No

7. Would you recommend the counselling service to other young people in need of help?

Yes No

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?

Yes No

14. Are you happy for your comments to be shared with your counsellor / therapist and other members of the Time to Listen Team?

Yes No

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