Listening Service Feedback Form

Please complete the following questions about the Listening Service to help us gain feedback and ensure the effectiveness of this service.

I felt that the Listener made an effort to introduce themselves to me  Required
I felt that the Listener cared about what I had to say  Required
I felt that the Listener spent enough time helping me through any issues  Required
I felt comfortable talking to the Listener about any issues/thoughts I had  Required
Do you feel that any of the above helped you?  Required
On what date was your last appointment?  Required

The next section is concerning your emotional well-being. If this is relevant to you and you would like to provide further feedback please complete this section. If not, please continue to the next section.

I felt I had nobody to turn to for support when needed  Required
I felt overwhelmed by my problems  Required
I felt that tension and anxiety have prevented me doing important things  Required
I felt generally unhappy  Required
If you agreed to any of these, would you say the Listening service was useful in overcoming these feelings?  Required

Your satisfaction with our service.

Please enter a number from 1 to 10.
We occasionally share anonymous feedback and testimonials on our social media. Please let us know if you consent to your feedback being shared or wish to opt out  Required

Listening Service Feedback Form

Please complete the following questions about the Listening Service to help us gain feedback and ensure the effectiveness of this service.

I felt that the Listener made an effort to introduce themselves to me  Required
I felt that the Listener cared about what I had to say  Required
I felt that the Listener spent enough time helping me through any issues  Required
I felt comfortable talking to the Listener about any issues/thoughts I had  Required
Do you feel that any of the above helped you?  Required
On what date was your last appointment?  Required

The next section is concerning your emotional well-being. If this is relevant to you and you would like to provide further feedback please complete this section. If not, please continue to the next section.

I felt I had nobody to turn to for support when needed  Required
I felt overwhelmed by my problems  Required
I felt that tension and anxiety have prevented me doing important things  Required
I felt generally unhappy  Required
If you agreed to any of these, would you say the Listening service was useful in overcoming these feelings?  Required

Your satisfaction with our service.

Please enter a number from 1 to 10.
We occasionally share anonymous feedback and testimonials on our social media. Please let us know if you consent to your feedback being shared or wish to opt out  Required