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* 1. Age

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* 2. Gender:

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* 3. Name of your counsellor:

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* 4. I was treated with respect by my counsellor.

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* 5. I flet understood by my counsellor.

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* 6. I made positive changes in my life as a result of the counselling.

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* 7. You were actively invovled in setting and meeting your goals.

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* 8. Your counsellor helped you gain awareness of your strengths and capacities.

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* 9. The time that passed between first contact with Pacific Centre and speaking to a counsellor was reasonable.

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* 10. Other comments:

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