Counseling Evaluation Form
A counseling evaluation form feedback assists the counselor improve his or her approach towards a client and also review progress after a session. The client can choose to remain anonymous by omitting their details like name, email address, contact addresses and time when filling the counseling evaluation form.
Name of Therapist: ____________________________________
Date (optional): _______________________________________
Name of client (optional): _______________________________
Email address of client (optional): _________________________
1. Was your counseling session:
(Check where appropriate)
A) Face to face
B) E-mail
C) Telephone
Ranking Scale
A) Totally B) Somewhat C) Not Helpful D) Bad
(Insert Rating)
2. Has the counseling been helpful? _______________________
3. Did the therapist realize what was needed to be done for you to reach your goals?
_____________________
4. Did you feel motivated at the end of the session?
_____________________
Ranking Scale
A) Excellent B) Very Good C) Satisfactory D) Poor
5. How effective was the counselor at listening to you? ___________________________
6. How can you rate the ability of the therapist to understand your problem? ____________
7. Can you recommend /refer another client to this therapist? YES___ NO____ (check where appropriate)
8. What is your overall rating to the therapist’s understanding of a client’s situation and providing a workable solution? _________________
………………………………………………………………….
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