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* 1. The location I saw my Counsellor was:

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* 2. The name of my Counsellor was:

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* 3. The person who took my initial call was courteous and helpful:

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* 4. My Counsellor fostered a safe and trusting environment

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* 5. My Counsellor was respectful of my thoughts and feelings:

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* 6. My Counsellor helped me set and reach my counselling goals:

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* 7. I am able to deal more effectively with issues in my life:

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* 8. I felt prepared for the completion of my counselling:

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* 9. Please comment on how your counselling experience was or was not helpful:

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* 10. My overall level of satisfaction with the service provided by CCPerth was:

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