Whitsunday Counselling and Support
Client Services Feedback Form

Whitsunday Counselling and Support is committed to ensuring all people who access their service are provided with a high
level standard of care.  To ensure this, we ask you to complete the survey below to assist us maintaining this.  Each survey is kept private and confidential.

What is your first impression of entering the facility?

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* 1. What is your first impression of entering the facility?

How did you feel when entering the service?

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* 2. How did you feel when entering the service?

Was confidentiality explained in your contact with practitioner?

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* 3. Was confidentiality explained in your contact with practitioner?

Were your expectation of the service met?

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* 4. Were your expectation of the service met?

Did you feel the support you received was professional?

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* 5. Did you feel the support you received was professional?

Were your expectations met?

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* 6. Were your expectations met?

Were you treated with respect?

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* 7. Were you treated with respect?

From entry to exit, did you receive competent and professional service?

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* 8. From entry to exit, did you receive competent and professional service?

Were you able to apply new skills and knowledge to your relationship/s or situations?

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* 9. Were you able to apply new skills and knowledge to your relationship/s or situations?

Would you recommend this service to others?

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* 10. Would you recommend this service to others?

We invite your comments about any aspect of the service you have received -what was useful or beneficial, what can be improved etc

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* 11. We invite your comments about any aspect of the service you have received -what was useful or beneficial, what can be improved etc

Which program relates to you?

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* 12. Which program relates to you?

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