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* 1. Please select your therapist

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* 2. My therapist listened to me effectively. 

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* 3. My therapist focused on what was important to me. 

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* 4. My therapist accepted what I said without judging me. 

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* 5. My therapist showed warmth toward me.

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* 6. My therapist fostered a safe and trusting environment.

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* 7. My therapist began and finished our sessions on time.

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* 8. The sessions with my therapist helped me with whatever originally led me to seek therapy.

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* 9. Any changes which might have occurred in me as a result of my counselling have been positive and welcome.

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* 10. My overall satisfaction with the service provided by my therapist is

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* 11. Based on my experience, I would recommend my therapist to others.

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* 12. Any Comments that you would like to share?

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