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* Who did you meet with?

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* Date

Date

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* 1.  My counsellor/worker understood and respected me.

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* 2.  Overall, I was satisfied with the service I received.

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* 3.  If I require help again, I would access this service.

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* 4.  Would you recommend this service/program to other people?

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* 5.  I received information about other services or resources that might help.

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* 6.  I participated in developing my goals/plan with my counsellor/worker.

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* 7.  We reviewed my progress and I received feedback from my counsellor/worker.

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* 8.  My counsellor/worker helped me focus on and utilize my strengths.

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* 9.  I have a better understanding of the issues and problems that brought me here.

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* 10.  My ability to manage the situation that brought me to Thunder Bay Counselling Centre has significantly improved.

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* 11.  Overall, the service I received had a positive outcome on the quality of my life.

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* 12 (a) Did you receive services in French

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* 12 (b) If yes, were you satisfied with those services?

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* 13.  Is there anything else that you would like to tell us?

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* Program

THANK YOU FOR EVALUATING OUR SERVICE!

T