Client Feedback Form - SAFECOM

We would be grateful if you would take a few minutes of your time to complete this questionnaire about your experiences with Human Psychology.

Your feedback is critical to ensuring that a high quality service is available to all of our clients and for the professional development of our psychologists.

ALL INFORMATION IS CONFIDENTIAL AND ANONYMOUS

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* 1. Psychologist Name (optional)

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* 2. It was easy to make an appointment.

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* 3. Reception staff were friendly and helpful.

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* 4. My privacy and confidentiality were maintained during my sessions.

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* 5. The counselling I received from my Psychologist has helped me.

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* 6. My Psychologist listened to me effectively.

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* 7. My Psychologist focused on what was important to me.

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* 8. My Psychologist fostered a safe and trusting environment.

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* 9. My Psychologist began and finished our sessions on time.

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* 10. I would be happy to recommend this service to someone I know.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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* 11. How many sessions have you utilised this year?

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* 12. Please make any comments which you feel may be helpful in improving our service.

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* 13. Follow-up
If you would you like to discuss any aspects of our services with the General Manager please indicate below. You will be contacted with the utmost discretion.

Yes

If yes, your name and phone number:

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* 1. Psychologist Name (optional)

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* 2. It was easy to make an appointment.

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* 3. Reception staff were friendly and helpful.

Question Title

* 4. My privacy and confidentiality were maintained during my sessions.

Question Title

* 5. The counselling I received from my Psychologist has helped me.

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* 6. My Psychologist listened to me effectively.

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* 7. My Psychologist focused on what was important to me.

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* 8. My Psychologist fostered a safe and trusting environment.

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* 9. My Psychologist began and finished our sessions on time.

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* 10. I would be happy to recommend this service to someone I know.

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* 11. How many sessions have you utilised this year?

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* 12. Please make any comments which you feel may be helpful in improving our service.

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* 13. Follow-upIf you would you like to discuss any aspects of our services with the General Manager please indicate below. You will be contacted with the utmost discretion.

* 13. Follow-up
If you would you like to discuss any aspects of our services with the General Manager please indicate below. You will be contacted with the utmost discretion.