Client Feedback Form Question Title * 1. Please select your therapist Chloe Sereda Brooke Raynsford Nicole Rider Jennifer White Tegan Tsubouchi Kelly Halonen Drue Wood Question Title * 2. My therapist listened to me effectively. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 3. My therapist focused on what was important to me. Strongly agree Agree Somewhat agree Neither agree nor disagree Somewhat disagree Disagree Strongly disagree Question Title * 4. My therapist accepted what I said without judging me. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 5. My therapist showed warmth toward me. Strongly agree Agree Somewhat agree Neither agree nor disagree Somewhat disagree Disagree Strongly disagree Question Title * 6. My therapist fostered a safe and trusting environment. Strongly agree Agree Somewhat agree Neither agree nor disagree Somewhat disagree Disagree Strongly disagree Question Title * 7. My therapist began and finished our sessions on time. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 8. The sessions with my therapist helped me with whatever originally led me to seek therapy. Strongly agree Agree Somewhat agree Neither agree nor disagree Somewhat disagree Disagree Strongly disagree Question Title * 9. Any changes which might have occurred in me as a result of my counselling have been positive and welcome. Strongly agree Agree Somewhat agree Neither agree nor disagree Somewhat disagree Disagree Strongly disagree Question Title * 10. My overall satisfaction with the service provided by my therapist is Very satisfied Satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Dissatisfied Very dissatisfied Question Title * 11. Based on my experience, I would recommend my therapist to others. Yes No Question Title * 12. Any Comments that you would like to share? Done