Please take a few minutes to evaluate our services. Your responses will be treated in the strictest confidence.

Please blacken the box that best describes your evaluation of the quality and impact of the counselling you received.

3 / 1

300%

1.The amount of service offered was satisfactory

Yes

No

2.The response time to my request for service was acceptable

Yes

No

3.The effectiveness of counselling

As a result of counselling:

Significantly 
Improved

Improved

Remained
the same

Became
Slightly Worse

Became
Worse

a) My ability to deal with the situation that brought me to THRIVE…

Significantly 
Improved

Improved

Remained
the same

Became
Slightly Worse

Became
Worse

b) My quality of life has…

Significantly 
Improved

Improved

Remained
the same

Became
Slightly Worse

Became
Worse

c) My situation at work has… (if applicable)

Significantly 
Improved

Improved

Remained
the same

Became
Slightly Worse

Became
Worse

4.The quality of counselling

Very
High

High

Medium

Low

Very
Low

a) My satisfaction with counselling has been...

Very
High

High

Medium

Low

Very
Low

b) My satisfaction with the agency....

Very
High

High

Medium

Low

Very
Low

c) My satisfaction with my counsellor...

Very
High

High

Medium

Low

Very
Low

d) My satisfaction with other staff members…

Very
High

High

Medium

Low

Very
Low

5.I would recommend Thrive Counselling:

Yes

No

6.What I like best about the service:

7.A change that THRIVE could consider:

8.Additional comments?

9.I am willing to have my comments used anonymously in information on Thrive Counselling (for example, on the website)

Yes

No

10.If you were dissatisfied with the service you received and would like a response to your concerns, please specify below, and provide an address and telephone number you can be reached at, if different from your file.  The Director of Programs or Executive Director of Thrive Counselling will contact you personally about your concerns.

Name:

Phone Number: