A counselling feedback survey is a kind of a survey which is used by counselling agencies or centres to get a feedback about the counselling services provided by the staff. These surveys are distributed amongst those who use the services of the counsellors for various reasons. These surveys are used to take the opinions of the respondents and to know whether or not they are satisfied with the counselling. Given below is one such sample of a counselling feedback survey that can be used by anyone for the purpose of reference.
Sample Counselling Feedback Survey:
Name of respondent
Age of respondent:
Contact number of respondent:
Name of counsellor:
Name of counselling centre:
Kindly answer all of the following given questions in the spaces which have been allotted.
Q1. Since when have you been taking counselling services from our agency?
a) Since one month
b) Since two months
c) Less than 6 months
d) More than 6 months
Q2. What are your views about your counsellor?
a) I am quite satisfied with my counsellor
b) I am not very satisfied with my counsellor
c) I am not at all satisfied with my counsellor
Q3. What are your opinions about the other additional services provided by the counselling centre?
a) Very good services
b) Services are satisfactory
c) Services could be improved
d) The services are not good
Q4. Are you satisfied with the behaviour, response and overall counselling efficiency of your counsellor?
a) Yes, I am very satisfied
b) Quite satisfied
c) Not very satisfied
d) No, I am not satisfied
Q5. Have you benefitted from the counselling that has been provided to you?
Q6. Do you have any suggestions or tips to give to your counsellor so as to improve their service? If yes, then please specify.