Post-Counseling Feedback Questionnaire
Please share your honest feedback about your recent counseling session. Your input helps us improve and provide better support.
Your Name
*
First Name
Last Name
Email Address (optional)
example@example.com
Session Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Counselor/Therapist Name
*
Overall, how satisfied were you with your session?
*
1
2
3
4
5
To what extent did you feel heard and understood?
*
1
2
3
4
5
How helpful was your session?
*
1
2
3
4
5
What was the most helpful aspect of your session?
What could be improved for future sessions?
Would you like to schedule a follow-up session?
Yes
No
Not sure
Submit Feedback
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