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HSC Counseling Services Client Satisfaction Survey
Page 1 of 1
Please take a few minutes to fill out the following survey. This will help us to improve the services we provide. Thank you!
1.
Referral Source:
*
Walk-in
Orientation
Referral
2.
Your age:
*
3.
Your gender:
*
M
F
4.
Your college:
*
5.
What type of counseling are you currently receiving?
*
Career
Individual
Couples
6.
How many times have you been seen for counseling?
*
5 or fewer
6 to 10
11 to 15
16 to 20
20 +
7.
How would you rate the quality of counseling you are receiving?
*
Excellent
Good
Fair
Poor
Very Poor
8.
Does your counselor demonstrate an ability to communicate effectively with you?
*
Definitely Yes
Yes
Undecided
No
Definitely No
9.
If you have concerns about counseling or dissatisfactions with your counselor, do you feel your counselor is open to discussing them with you?
*
Very Open
Open
Undecided
Closed
Very Closed
10.
Have the problems you brought to counseling changed for the better or worse as a result of counseling?
*
Much Better
Better
No Change
Worse
Much Worse
11.
How effectively are you coping with those problems now, compared to when you began counseling?
*
Much Better
Better
No Change
Worse
Much Worse
12.
Overall, how satisfied are you with the counseling you are receiving?
*
Very Satisfied
Satisfied
Indifferent
Dissatisfied
Very Dissatisfied
13.
If you were to seek help again and were still eligible to receive services, would you return to Student Counseling Services
*
Definitely
Probably
Maybe
Probably Not
Definitely Not
14.
If a peer was in need of similar help, would you recommend us to her/him?
*
Definitely
Probably
Maybe
Probably Not
Definitely Not
15.
If you chose not to continue counseling, what would be the reason?
*
16.
Comments: