Counselling Feedback Form

You have recently received counselling from Carers Milton Keynes. We would be very grateful to receive your feedback on this aspect of our service so that we can ensure a high quality service that is appropriate for carers.

    Name of Counsellor (required)

    Date of counselling (required)

    Have the counselling sessions made a positive difference to your life in general?

    Have the counselling sessions made a positive difference to your caring role?

    On a scale of 1-5, with 1 being not at all useful and 5 being very useful, overall how useful did you find your sessions?
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    Any further comments or concerns?

    Name (optional)

    Do you consent to this information being shared with the Counsellor?